title: Prevalence of diabetes mellitus in 6050 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis.
abstract: OBJECTIVE
  GH deficiency (GHD) in adults is characterized by a tendency toward obesity and an adverse body composition with visceral fat deposit and may thus predispose to the development of type 2 diabetes mellitus. The aim of this study was to assess the observed prevalence proportion (PP) and observed PP over expected PP ratio (standardized prevalence proportion ratio, SPR) of diabetes according to International Diabetes Federation criteria in a large cohort of GH-untreated adult-onset GHD patients.
  
  
  METHODS
  Associations between baseline variables and diabetes prevalence in 6050 GHD patients from KIMS (Pfizer International Metabolic Database) were studied and robust Poisson-regression analyses were performed. Comparisons between baseline status and HbA1c categories in the nondiabetic patients were done with covariance analysis. P values <0.05 were considered statistically significant.
  
  
  RESULTS
  PP was 9.3% compared with the expected 8.2%. SPR was 1.13 (95% confidence intervals (95% CIs), 1.04-1.23), which was significantly increased in females (1.23; 95% CI, 1.09-1.38%) but not in males (SPR 1.04; 95% CI, 0.92-1.17%). PP increased significantly by age, familial diabetes, country selection, BMI, waist circumference, number of pituitary deficiencies, and GHD etiology. SPR decreased significantly by age and increased significantly by BMI, waist circumference, and IGF1 SDS. Multiple regression model showed that the most important impact on SPR was from age and BMI. HbA1c values of 6.0-6.5% were found in 9.5% of nondiabetic patients and were associated with higher BMI and waist circumference.
  
  
  CONCLUSIONS
  GHD is associated with an increased prevalence of diabetes, largely to be explained by the adverse body composition. These data urge toward early initiation of lifestyle modification measures.
authors.affiliation: Antwerp Centre for Endocrinology, Grotesteenweg 556, B-2600 Berchem, Antwerp, Belgium. roger.abs@skynet.be
authors.forename: Roger
authors.initials: R
authors.lastname: Abs
authors.forename: Anders F
authors.initials: AF
authors.lastname: Mattsson
authors.forename: Maria
authors.initials: M
authors.lastname: Thunander
authors.forename: Johan
authors.initials: J
authors.lastname: Verhelst
authors.forename: Miklós I
authors.initials: MI
authors.lastname: Góth
authors.forename: Patrick
authors.initials: P
authors.lastname: Wilton
authors.forename: Maria
authors.initials: M
authors.lastname: Kołtowska-Häggström
authors.forename: Anton
authors.initials: A
authors.lastname: Luger
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D016012:Poisson Distribution; D015995:Prevalence; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; C517652:hemoglobin A1c protein, human