GH Replacement Improves Quality of Life and Metabolic Parameters in Cured Acromegalic Patients with Growth Hormone Deficiency

Author:

Giavoli Claudia12,Profka Eriselda12,Verrua Elisa12,Ronchi Cristina L.3,Ferrante Emanuele12,Bergamaschi Silvia12,Sala Elisa12,Malchiodi Elena12,Lania Andrea G.4,Arosio Maura15,Ambrosi Bruno6,Spada Anna12,Beck-Peccoz Paolo12

Affiliation:

1. Department of Clinical Sciences and Community Health (C.G., E.P., E.V., E.F., S.B., E.S., E.M., M.A., A.S., P.B.-P.), University of Milan,

2. Endocrinology and Diabetology Unit (C.G., E.P., E.V., E.F., S.B., E.S., E.M., A.S., P.B.-P.), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinico, Milan, Italy

3. University Hospital (C.L.R.), 97080 Wuerzburg, Germany

4. BIOMETRA Department (A.G.L.), University of Milan and Endocrine Unit, Humanitas Cinical and Research Center, Rozzano, 20089 Milan, Italy

5. Unit of Endocrine Diseases (M.A.), Ospedale S. Giuseppe Multimedica, 20123 Milan, Italy

6. Department of Medical and Surgical Sciences (B.A.), University of Milan, Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, 20097 San Donato Milanese, Italy

Abstract

Objective: Effects of GH replacement in patients with GH deficiency (GHD) after a cure for acromegaly so far have been poorly studied, although its prevalence among acromegalic patients may reach the 60%. The aim of the study was to evaluate whether metabolic parameters and quality of life are improved by GH replacement in patients with prior acromegaly and severe GHD. Design and Methods: This was a prospective study on 42 GHD subjects [22 men, mean age (sd): 48 ± 10]: 10 acromegalics treated with recombinant human GH (group A), 12 acromegalics who refused treatment (group B), and 20 subjects operated for nonfunctioning pituitary adenoma on recombinant human GH (group C). Serum IGF-I levels, lipid profile, glucose levels (fasting and after an oral glucose tolerance test), glycosylated hemoglobin, insulin resistance (homeostasis model assessment insulin resistance index), anthropometric parameters (body mass index, waist circumference, body composition), and quality of life (Questions on Life Satisfaction-Hypopituitarism Z-scores) were evaluated at baseline and after 12 and 36 months. Results: At baseline, group B showed higher IGF sd score than group A and C, as well as better quality of life and higher post-oral glucose tolerance test glucose levels than group A. After 12-months, similarly in group A and C, the IGF-I sd score significantly increased, and body composition and lipid profile improved, without deterioration of glucose tolerance. Quality of life significantly improved too, and the baseline difference between group A and B disappeared. Results were confirmed after 36 months. Conclusions: In GHD acromegalic patients, GH therapy improved body composition, lipid profile, and quality of life as in patients with GHD due to nonfunctioning pituitary adenoma, without negative effects on glucose metabolism. GH replacement therapy should be considered in these patients, as in patients with GHD from other causes.

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

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