Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease
Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease
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DOI：
10.1530/eje-09-0836
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发表时间：
2010-04-01
影响因子：
5.8
通讯作者：
Biller, Beverly M. K.
中科院分区：
文献类型：
--
作者：
Hoybye, Charlotte;Ragnarsson, Oskar;Biller, Beverly M. K.
目的：库欣病（CD）缓解期患者有许多临床特征，这些特征很难与伴随的GH缺乏症（GHD）区分开来。在这项研究中，我们评估了一大批对照CD患者的GHD特征，并评估了GH治疗的效果。设计和方法：数据来自辉瑞国际代谢数据库（KIMS）。对未匹配的CD （n=684，女性占74%）和无功能垂体腺瘤（NFPA, n=2990，女性占39%）患者的背景特征进行回顾性横断面比较。此外，对年龄和性别匹配的可控CD患者（n=322）和NFPA患者（n=748）进行了3年生长激素替代的纵向评估。结果：横断面研究显示，在患有高血压、骨折和糖尿病的CD组中，GHD的诊断明显延迟。在纵向匹配研究中，CD组在基线时具有更好的代谢谱，但较差的生活质量（QoL），这是通过成人GHD疾病特异性问卷QoL评估来评估的。生长激素治疗3年后（3年平均剂量为CD组0.39 mg/天，NFPA组0.37 mg/天），总胆固醇和低密度脂蛋白胆固醇下降，而葡萄糖和HbAlc升高。观察到生活质量的改善，CD组的改善更大(-6 CD组与-5 NFPA组，P
Objective: Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment.Design and methods: Data were obtained from KIMS, the Pfizer International Metabolic Database. A retrospective cross-sectional comparison of background characteristics in unmatched cohorts of patients with CD (n=684, 74% women) and nonfunctioning pituitary adenoma (NFPA; n=2990, 39% women) was conducted. In addition, a longitudinal evaluation of 3 years of GH replacement in a subset of patients with controlled CD (n=322) and NFPA (n=748) matched for age and gender was performed.Results: The cross-sectional study showed a significant delay in GHD diagnosis in the CD group, who had a higher prevalence of hypertension, fractures, and diabetes mellitus. In the longitudinal, matched study, the CD group had a better metabolic profile but a poorer quality of life (QoL) at baseline, which was assessed with the disease-specific questionnaire QoL-assessment of GHD in adults. After 3 years of GH treatment (mean dose at 3 years 0.39 mg/day in CD and 0.37 mg/day in NFPA), total and low-density lipoprotein cholesterol decreased, while glucose and HbAlc increased. Improvement in QoL was observed, which was greater in the CD group (-6 CD group versus -5 NFPA group, P