title: Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis.
abstract: OBJECTIVE
  An increased risk of cardiovascular morbidity and mortality in adult GH deficiency (GHD) may be related to hypopituitarism but also to the presence of the metabolic syndrome (MetS). Our objective was to investigate the characteristics and prevalence of MetS as well as its comorbidities in adult GHD. Design In KIMS (Pfizer International Metabolic Database) 2479 patients with severe adult-onset GHD, naïve to GH replacement, with complete information on all MetS components were found. MetS was defined according to the National Cholesterol Education Program's Adult Treatment Panel III (NCEP) and the International Diabetes Foundation (IDF).
  
  
  METHODS
  The prevalence of MetS was calculated and compared with previously published data from the normal population. Associations were assessed between background variables, baseline variables, comorbidities, and MetS.
  
  
  RESULTS
  MetS was present in 43.1% (NCEP) and in 49.1% (IDF) of patients, clearly higher than data from the normal population (20-30%). MetS prevalence was related to age, GHD duration, and body mass index (BMI), but not to GHD severity, extent of hypopituitarism, or etiology of pituitary disease. Adjusted for age, gender, and BMI, patients with MetS had a higher prevalence ratio for diabetes mellitus: 4.65 (95% confidence interval (CI): 3.29-6.58), for cardiovascular morbidity: 1.91 (95% CI: 1.33-2.75), and for cerebrovascular morbidity: 1.77 (95% CI: 1.09-2.87) than patients without MetS.
  
  
  CONCLUSIONS
  MetS is highly prevalent in GHD and is associated with a higher prevalence ratio for comorbidities. The presence of MetS in GHD may therefore contribute to the increased risk of cardiovascular morbidity and mortality found in these patients.
authors.affiliation: Department of Endocrinology, ZNA Middelheim Antwerp, Lindendreef 1, Antwerp, Belgium. johan.verhelst@zna.be
authors.forename: Johan
authors.initials: J
authors.lastname: Verhelst
authors.forename: Anders F
authors.initials: AF
authors.lastname: Mattsson
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
authors.forename: Maria
authors.initials: M
authors.lastname: Thunander
authors.forename: Miklós I
authors.initials: MI
authors.lastname: Góth
authors.forename: Maria
authors.initials: M
authors.lastname: Koltowska-Häggström
authors.forename: Roger
authors.initials: R
authors.lastname: Abs
mesh_terms: D000328:Adult; D000367:Age Factors; D015331:Cohort Studies; D005260:Female; D020249:Hormone Replacement Therapy / Q000379:methods; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence
chemical_list: D019382:Human Growth Hormone