Abstract | BACKGROUND: Partial GH deficiency (GHD) in adults is poorly studied. OBJECTIVE: The objective of the study was to investigate the natural history and clinical implications of partial GHD. STUDY DESIGN: This was an analytical, observational, prospective, case-control study. PATIENTS: Twenty-seven hypopituitary patients (15 women, ages 20-60 yr) and 27 controls participated in the study. MAIN OUTCOME MEASURES: RESULTS: At study entry, partial GHD patients had significantly lower IGF-I and HDL-cholesterol levels and homeostasis model assessment index than controls. During the 60 months of median follow-up, 11 patients had severe GHD (40.7%), seven normalized their GH response (25.9%), and nine showed persistently partial GHD (33.3%). Patients with developed severe GHD at baseline had similar age and body mass index and lower GH peak (11.5 +/- 1.8 vs. 14.3 +/- 1.5 and 12.8 +/- 1.1 microg/liter, P = 0.008) and IGF-I SDS (-0.88 +/- 0.48 vs. 0.15 +/- 0.58 and -0.42 +/- 0.78; P = 0.01) than the patients with normal GH secretion or partial GHD. Severe GHD was accompanied by decreased IGF-I SDS and increased total to HDL cholesterol ratio, triglycerides, homeostasis model assessment index, and carotid intima-media thickness; normalization of GH secretion was accompanied by increased IGF-I SDS. By receiving-operator characteristic analysis, predictors of severe GHD were a baseline GH peak after GHRH+ARG of 11.5 microg/liter (sensitivity 64%, specificity 94%) and a baseline IGF-I SDS of -0.28 (sensitivity 91%, specificity 63%). CONCLUSIONS: Of 27 patients with partial GHD after pituitary surgery, 40.7% developed severe GHD and 25.9% normalized their GH response. With the assay used, changes in the GH peak response to GHRH+ARG were accompanied by changes in the IGF-I SDS, metabolic profile, and carotid IMT. A peak GH of 11.5 microg/liter or less and IGF-I SDS -0.28 or less were highly predictive of delayed deterioration of GH secretion.
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Authors | Annamaria Colao, Carolina Di Somma, Stefano Spiezia, Francesca Rota, Rosario Pivonello, Silvia Savastano, Gaetano Lombardi |
Journal | The Journal of clinical endocrinology and metabolism
(J Clin Endocrinol Metab)
Vol. 91
Issue 6
Pg. 2191-200
(Jun 2006)
ISSN: 0021-972X [Print] United States |
PMID | 16537686
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Cholesterol, HDL
- Human Growth Hormone
- Growth Hormone-Releasing Hormone
- Arginine
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Topics |
- Adult
- Arginine
(pharmacology)
- Atherosclerosis
(etiology)
- Cardiovascular Diseases
(etiology)
- Carotid Artery, Common
(pathology)
- Case-Control Studies
- Cholesterol, HDL
(blood)
- Female
- Follow-Up Studies
- Growth Hormone-Releasing Hormone
(pharmacology)
- Human Growth Hormone
(deficiency, metabolism)
- Humans
- Male
- Middle Aged
- Prospective Studies
- Risk
- Tunica Intima
(pathology)
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