Growth hormone replacement does not increase serum prostate-specific antigen in hypopituitary men over 50 years.
OBJECTIVE
Epidemiological studies have shown an increased risk for prostate carcinoma in men with serum IGF-I in the upper part of the age-related reference range. Recombinant human GH (rhGH) is widely used in patients with GH deficiency, usually raising the serum IGF-I levels into the normal range: safety surveillance is therefore mandatory, with particular regard to neoplasia. The aim was to examine whether rhGH replacement in hypopituitary adults is associated with changes in serum prostate-specific antigen (PSA) as a surrogate marker of changes in prostatic growth.


METHODS
A prospective longitudinal study was used with a median follow-up of 22 (range 2.5-32) months, in which 41 men aged over 50 years with adult onset hypopituitarism and GH deficiency during rhGH replacement were examined. Serum PSA and IGF-I were measured at baseline and at latest follow-up.


RESULTS
Mean serum PSA remained unchanged during rhGH replacement, with a median follow-up of 2 years. No correlation was found between the individual changes in serum IGF-I and changes in serum PSA.


CONCLUSIONS
These data are reassuring thus far regarding the safety of GH replacement in relation to the prostate in this patient group.
le Roux
C W
CW
Department of Endocrinology, St Bartholomew's and the Royal London School of Medicine and Dentistry, St Bartholomew's Hospital, London EC1A 7BE, UK.
Jenkins
P J
PJ
Chew
S L
SL
Camacho-Hübner
C
C
Grossman
A B
AB
Besser
G M
GM
Monson
J P
JP
D000368:Aged; D005500:Follow-Up Studies; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood* / Q000188:drug therapy*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D017430:Prostate-Specific Antigen