Baseline characteristics and the effects of two years of growth hormone replacement therapy in adults with growth hormone deficiency previously treated for Cushing's disease.
OBJECTIVE
To determine baseline characteristics and the effects of 2 years of GH replacement therapy on body composition, muscle strength, bone mass, and metabolic indices in GH-deficient (GHD) adults previously treated for pituitary-dependent Cushing's disease.


METHODS
A single-centre, open-labelled, prospective study.


METHODS
Fifteen consecutive GHD adults previously treated for pituitary-dependent Cushing's disease (CD group) and 15 closely matched GHD adults with previous nonfunctioning hypopituitary disease (NF group) were included. All patients had adult-onset GH deficiency.


RESULTS
The mean dose of GH was similar in both study groups during the 2-year treatment. At baseline, diastolic blood pressure was higher, and lumbar (L2-L4) bone mineral density (BMD) was lower, in the CD group than in the NF group. The increase in lean mass in response to GH therapy, as measured by dual-energy X-ray absorptiometry (DEXA), was less marked in the CD group. GH replacement therapy reduced diastolic blood pressure only in the CD group. The patients in the CD group had greater treatment response in lumbar (L2-L4) spine BMD and in isometric and isokinetic knee extension strength than the patients in the NF group. At study end, no difference remained between the two study groups.


CONCLUSIONS
This study revealed differences in the baseline characteristics between GHD patients previously treated for Cushing's disease as compared with closely matched GHD patients with previous nonfunctioning hypopituitary disease. The 2-year GH replacement therapy eliminated all the differences between the two study groups.
Johannsson
Gudmundur
G
Research Centre for Endocrinology and Metabolism, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg, Sweden.
Sunnerhagen
Katharina Stibrant
KS
Svensson
Johan
J
D015502:Absorptiometry, Photon; D001823:Body Composition / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D003480:Cushing Syndrome / Q000503:physiopathology / Q000628:therapy; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000627:therapeutic use; D018709:Statistics, Nonparametric
D011994:Recombinant Proteins; D019382:Human Growth Hormone