Impact of the primary aetiology upon the clinical outcome of adults with childhood-onset GH deficiency.
OBJECTIVE
The impact of the aetiology of childhood-onset GH deficiency (CO-GHD) on the clinical presentation during adulthood and the response to GH replacement has been poorly defined. Our study aims to characterize CO-GHD in adults due to different aetiologies and evaluate the effect of 2 years of GH replacement therapy.


METHODS
Data from 353 adults with CO-GHD from Pfizer International Metabolic Database KIMS were retrospectively grouped according to GHD aetiology: non-organic disorder (n=147), organic pituitary disease (n=159), and brain tumour (n=47). Extent of pituitary dysfunction, IGF-I concentration, lipid concentrations and quality-of-life (QoL) were assessed at baseline and after 2 years of GH replacement.


RESULTS
GHD was diagnosed at a later age in the organic pituitary group than in the other groups, resulting in a shorter duration of GH treatment during childhood. However, the final height was greater in the organic pituitary group. Panhypopituitarism was most common in the non-organic disorder and in the organic pituitary groups, while isolated GHD was more prominent in the brain tumour group. Serum IGF-I levels were the lowest in the non-organic group. QoL was the poorest in the brain tumour group. Lipid profile and QoL improved significantly during GH replacement.


CONCLUSIONS
The adverse consequences of CO-GHD in adulthood vary between aetiologies, but improve similarly with GH treatment. It is, therefore, important to consider retesting all patients with CO-GHD in early adulthood and, if persistent severe GHD is confirmed, recommence GH replacement.
Hoybye
Charlotte
C
Department of Endocrinology, Metabolism and Diabetology, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden. charlotte.hoybye@karolinska.se
Jönsson
Peter
P
Monson
John P
JP
Koltowska-Häggström
Maria
M
Hána
Václav
V
Geffner
Mitchell
M
Abs
Roger
R
D000293:Adolescent; D000328:Adult; D001827:Body Height; D004393:Dwarfism, Pituitary / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology* / Q000523:psychology; D008297:Male; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D016896:Treatment Outcome
D019382:Human Growth Hormone