title: Analysis of short- and long-term metabolic effects of growth hormone replacement therapy in adult patients with craniopharyngioma and non-functioning pituitary adenoma.
abstract: OBJECTIVE
  Adult patients operated for craniopharyngioma develop more frequently GH deficiency (GHD) than patients operated for non-functioning pituitary adenoma (NFPA). The aim of the study was to compare both short- (1 year) and long-term (5 years) effects of rhGH in 38 GHD adult patients (19 operated for Craniopharyngioma (CP) and 19 for NFPA).
  
  
  METHODS
  IGF-I levels, body composition (BF%), BMI, lipid profile and glucose homeostasis were evaluated in all patients. Pituitary MRI was performed at baseline and during follow-up, as needed.
  
  
  RESULTS
  At baseline no difference between the two groups was observed, apart from a higher prevalence of diabetes insipidus in CP patients (79 vs 21%). After 12 months, IGF-I SDS normalized and BF% significantly decreased only in the NFPA group. During long-term treatment, decrease in BF% and improvement in lipid profile shown by reduction in total- and LDL-cholesterol were present in NFPA group only, while increase in insulin levels and HbA1c and decrease of QUICKI were observed in CP patients only. Accordingly, after long-term therapy, the prevalence of metabolic syndrome (MS) was significantly higher in CP than in NFPA group (37% in CP and in 5% in NFPA group; p < 0.05).
  
  
  CONCLUSIONS
  The present data suggest that CP patients are less sensitive to the positive rhGH effects on lipid profile and BF% and more prone to insulin sensitivity worsening than NFPA patients, resulting in increased prevalence of MS in CP only.
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy. eprofka@gmail.com.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy. eprofka@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Profka
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Giavoli
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bergamaschi
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Ferrante
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Malchiodi
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Sala
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Verrua
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Rodari
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Filopanti
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Beck-Peccoz
authors.affiliation: Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy.|Department of Medical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Spada
mesh_terms: D000236:Adenoma / Q000097:blood* / Q000188:drug therapy / Q000378:metabolism* / Q000601:surgery; D000328:Adult; D003397:Craniopharyngioma / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage / Q000172:deficiency / Q000494:pharmacology*; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood*; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000601:surgery; D055815:Young Adult
chemical_list: D019382:Human Growth Hormone
keywords: Craniopharyngioma; GH deficiency; Glucose homeostasis; rhGH replacement