The severity of growth hormone deficiency in adults with pituitary disease is related to the degree of hypopituitarism.
AffiliationDepartment of Endocrinology, Christie Hospital, Manchester, UK.
MetadataShow full item record
AbstractOBJECTIVE: A number of studies of the effect of GH replacement therapy in adult patients with GH deficiency have been published, but the definition of GH deficiency has varied considerably. In order to define severe GH deficiency more critically we have determined GH status in the context of gonadotrophin, ACTH and TSH secretion in adult patients with pituitary disease. DESIGN: Analysis of peak GH response to an insulin tolerance test performed during comprehensive assessment of pituitary function. PATIENTS: One hundred and ninety non-acromegalic patients (96 male) with pituitary disease whose ages ranged from 16 to 72 (mean 39.4) years. MEASUREMENTS: The patients were divided into four groups according to the number of anterior pituitary hormone deficiencies demonstrated; isolated GH deficiency (GHD0), or GH deficiency plus an additional one, two or three pituitary hormone deficits (GHD1, GHD2, GHD3). RESULTS: The four groups were matched for age and blood glucose nadir during the ITT. The median (interquartile range) GH peaks were GHD0, 10.0 (5.4-16); GHD1, 4.0 (2.7-7.7); GHD2, 2.0 (1-2.9); GHD3, 1.8 (1-3.2) mU/l. There was a significant downward trend in the medians (P < 0.0001). The differences between GHD0 and GHD1, and GHD1 and GHD2, were highly significant (P < 0.0001); however, there was no difference between GHD2 and GHD3. Ninety-one per cent of patients in combined groups GHD2 and GHD3, 55% in GHD1 and 24% in GHD0 had a peak GH < 5 mU/l. CONCLUSIONS: Our study has shown that GH deficiency is variable according to the degree of hypopituitarism present and that the greater the number of pituitary hormone deficits the more severe the GH deficiency. These observations will help to clarify the diagnosis of GH deficiency in adult life.
CitationThe severity of growth hormone deficiency in adults with pituitary disease is related to the degree of hypopituitarism. 1994, 41 (4):511-6 Clin. Endocrinol. (Oxf)
- How many tests are required to diagnose growth hormone (GH) deficiency in adults?
- Authors: Lissett CA, Thompson EG, Rahim A, Brennan BM, Shalet SM
- Issue date: 1999 Nov
- The diagnosis of severe growth hormone deficiency in elderly patients with hypothalamic-pituitary disease.
- Authors: Toogood AA, Jones J, O'Neill PA, Thorner MO, Shalet SM
- Issue date: 1998 May
- The evolution of radiation-induced growth hormone deficiency in adults is determined by the baseline growth hormone status.
- Authors: Toogood AA, Ryder WD, Beardwell CG, Shalet SM
- Issue date: 1995 Jul
- Hexarelin as a test of pituitary reserve in patients with pituitary disease.
- Authors: Korbonits M, Kaltsas G, Perry LA, Grossman AB, Monson JP, Besser GM, Trainer PJ
- Issue date: 1999 Sep
- The prevalence of severe growth hormone deficiency in adults who received growth hormone replacement in childhood [see comment].
- Authors: Nicolson A, Toogood AA, Rahim A, Shalet SM
- Issue date: 1996 Mar