title: Comorbidity and cardiovascular risk factors in adult GH deficiency following treatment for Cushing's disease or non-functioning pituitary adenomas during childhood.
abstract: OBJECTIVE
  Cushing's disease (CD) and non-functioning pituitary adenoma (NFPA) are rare in paediatric patients. The aim of this study was to describe long-term consequences in adults with GH deficiency (GHD) treated for CD or NFPA during childhood.
  
  
  METHODS
  This was a retrospective analysis of data from KIMS (Pfizer International Metabolic Database). Background characteristics, anthropometry and comorbidity were studied in 47 patients diagnosed with childhood-onset (CO)-CD and 62 patients with CO-NFPA. Data from 100 ACTH-sufficient patients with CO-idiopathic hypopituitarism (CO-Idio) were used for comparison. Cardiovascular risk profile was analysed at baseline and at 1 year on GH treatment in a subgroup of patients (17 CO-CD, 24 CO-NFPA and 55 CO-Idio) not receiving GH treatment at study entry.
  
  
  RESULTS
  The median age at diagnosis of pituitary tumour was 14.0 years (range 10-17) in patients with CO-CD and 13.7 years (range 8-17) in CO-NFPA. In addition to GHD, 41% of patients with CO-CD had three or four other pituitary hormone deficiencies compared with 78% of patients with CO-NFPA (P<0.001). Eighty-nine per cent of patients with CO-CD had height SDS lower than 0 compared with 61% of patients with CO-NFPA (P=0.002). Hypertension was more common in CO-CD compared with CO-Idio (23 vs 9%, P=0.018). At 1 year on GH treatment, total- and low-density lipoprotein-cholesterol decreased significantly in CO-CD but not in CO-NFPA.
  
  
  CONCLUSIONS
  Adult patients with GHD following treatment for paediatric CD and NFPA have long-term adverse consequences. Despite more severe hypopituitarism in CO-NFPA, patients with CO-CD have more frequently compromised final stature.
authors.affiliation: Department of Endocrinology, Sahlgrenska University Hospital and University of Gothenburg, Gröna Stråket 8, Gothenburg, Sweden. oskar.ragnarsson@medic.gu.se
authors.forename: Oskar
authors.initials: O
authors.lastname: Ragnarsson
authors.forename: Charlotte
authors.initials: C
authors.lastname: Höybye
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Jönsson
authors.forename: Ulla
authors.initials: U
authors.lastname: Feldt-Rasmussen
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Johannsson
authors.forename: Beverly M K
authors.initials: BM
authors.lastname: Biller
authors.forename: Maria
authors.initials: M
authors.lastname: Koltowska-Häggström
mesh_terms: D000236:Adenoma / Q000150:complications / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D002648:Child; D015897:Comorbidity; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D008297:Male; D008875:Middle Aged; D047748:Pituitary ACTH Hypersecretion / Q000150:complications / Q000453:epidemiology*; D010911:Pituitary Neoplasms / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone