Effect of growth hormone replacement therapy on pituitary hormone secretion and hormone replacement therapies in GHD adults.
OBJECTIVE
We tested the impact of commencement of GH replacement therapy in GH-deficient (GHD) adults on the circulating levels of other anterior pituitary and peripheral hormones and the need for re-evaluation of other hormone replacement therapies, especially the need for dose changes.


METHODS
22 GHD patients were investigated in a double-blind randomized study and 90 GHD patients in an open study at baseline and after 6 and 12 months of GH replacement therapy.


RESULTS
In the placebo-controlled trial, the FT(3) levels increased after 6 months in the GH-treated group, and in the open study the FT(3) levels tended to increase. Other hormone concentrations did not change in either part of the study. Four patients required an increase in thyroxine dose, while 2 patients needed dose reduction. One originally euthyroid patient required thyroxine replacement. Two patients with originally conserved pituitary-adrenal function developed ACTH insufficiency. The hydrocortisone dose was increased in 1 and decreased in 1 of the 66 patients with secondary hypocortisolism. None of the females required any adjustment of sex hormone replacement therapy. Two of 37 males needed dose increase of testosterone, while 1 needed dose reduction.


CONCLUSIONS
GH replacement therapy required dose adjustments regarding other hormone replacement therapies in 12.2% (n = 11), while initiation of new hormone replacement was performed in 3.3% (n = 3) of the 90 patients during the 1-year follow-up. Monitoring of pituitary hormone axes is advisable after commencement of GH replacement therapy, since changes of hormone replacement therapy was observed in a small but clinically significant number of patients.
Hubina
Erika
E
Department of Medicine, National Medical Center, Budapest, Hungary.
Mersebach
Henriette
H
Rasmussen
Ase Krogh
AK
Juul
Anders
A
Sneppen
Simone Bjerregaard
SB
Góth
Miklós I
MI
Feldt-Rasmussen
Ulla
U
D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006066:Gonads / Q000378:metabolism; D013006:Growth Hormone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006728:Hormones / Q000008:administration & dosage / Q000097:blood; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000378:metabolism; D010907:Pituitary Hormones / Q000378:metabolism*; D011388:Prolactin / Q000097:blood; D043202:Steroid Metabolism, Inborn Errors / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism*; D013961:Thyroid Gland / Q000378:metabolism
D006728:Hormones; D010907:Pituitary Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D011388:Prolactin; D013006:Growth Hormone