title: Effects of GH replacement therapy on thyroid volume and nodule development in GH deficient adults: a retrospective cohort study.
abstract: OBJECTIVE
  Despite the well-known effects of GH/IGF1 signaling on the thyroid, few data are available on the risk of developing nodular goiter in hypopituitary subjects during GH replacement therapy (GHRT). We aimed to define the effects of GH therapy on thyroid volume (TV) and nodular growth.
  
  
  METHODS
  The records of 96 subjects (47 males and 49 females, median age 48 years) with GH deficit (GHD) were investigated. Seventy also had central hypothyroidism (CH). At the time of our retrospective evaluation, median treatment duration was 5 years.
  
  
  RESULTS
  Pre-treatment TV was smaller in GHD patients than in healthy subjects (P=0.030). During GH treatment, TV significantly increased (P=0.016 for the entire group and P=0.014 in euthyroid GHD patients). Before starting GH therapy, 17 patients harbored thyroid nodules. During GH therapy, nodule size increased slightly in seven patients, and new thyroid nodules occurred in nine patients. Among the 79 patients without pre-existing thyroid nodules, 17 developed one or more nodules. There was no difference in the prevalence of CH in GHD patients with or without thyroid nodules (P=0.915; P=0.841, when patients with pre-therapy nodular goiter were excluded), the main predictor for nodule development being serum IGF1 (P=0.038).
  
  
  CONCLUSIONS
  GHRT is associated with TV's increase in GHD patients. Thyroid nodules developed in 27% of patients, mainly in relation to pre-therapy IGF1 levels, independently of normal or impaired TSH stimulation.
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy curto.loren@libero.it.
authors: Lorenzo
authors: L
authors: Curtò
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Salvatore
authors: S
authors: Giovinazzo
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Angela
authors: A
authors: Alibrandi
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Alfredo
authors: A
authors: Campennì
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Francesco
authors: F
authors: Trimarchi
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Salvatore
authors: S
authors: Cannavò
authors: Unit of EndocrinologyDepartment of Clinical and Experimental Medicine, University of Messina, AOU Policlinico 'G. Martino' (Pad H, Floor 4), Via Consolare Valeria, 1, Messina 98125, ItalyDepartment of Statistical Sciences (SEFISAST)Unit of Nuclear MedicineDepartment of Biomedical Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy.
authors: Rosaria Maddalena
authors: RM
authors: Ruggeri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight / Q000187:drug effects; D015331:Cohort Studies; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy / Q000009:adverse effects*; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000473:pathology; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D013961:Thyroid Gland / Q000000981:diagnostic imaging / Q000187:drug effects / Q000254:growth & development*; D013963:Thyroid Hormones / Q000097:blood; D016606:Thyroid Nodule / Q000139:chemically induced* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D007328:Insulin; D013963:Thyroid Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone