Wednesday, October 29, 2008

Growth hormone replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

CLINICAL STUDY
Growth hormone replacement in hypopituitarism improves lipid profile and quality of life independently of changes in obesity variables

Pascale Abrams, Hugo Boquete, Hugo Fideleff, Ulla Feldt-Rasmussen, Patrick Wilton, Roger Abs, Maria Koltowska-Haggstrom and Peter Jonsson

P Abrams, endocrinology, university hospital antwerp, antwerp, 2650, Belgium
H Boquete, Hospital T Alvarez, Buenos Aires, Argentina
H Fideleff, Endocrinology Unit, Hospital Municipal T. Alvarez, Buenos Aires, Argentina
U Feldt-Rasmussen, National University Hospital, Copenhagen, Denmark
P Wilton, 7KIGS-KIMS-ACROSTUDY Medical Outcomes, Pfizer endocrine Care, New York, United States
R Abs, Endocrinology, University of Antwerp, Wilrijk, Belgium
M Koltowska-Haggstrom, KIMS Medical Outcomes, Pfizer Endocrine Care, Sollentuna, Sweden
P Jonsson, KIMS Medical Outcomes, Pfizer Endocrine Care, Sollentuna, Sweden

Correspondence: Pascale Abrams, Email: pascale.abrams@belgacom.net

Abstract

Objective: Growth hormone deficiency (GHD) in adults is characterized by elevated body mass index (BMI), increased waist girth (WG) and increased fat mass (FM). Information about how these indicators of obesity affect the lipid profile and quality of life (QoL) of GHD subjects is scarce. It is also unclear how changes in these indicators through GH replacement influence lipids and QoL.

Design and Methods: Adult GHD subjects from the Pfizer International Metabolic Database were grouped according to BMI (n = 291 with BMI <25 kg/m2, n = 372 with BMI 25-30 kg/m2, n = 279 with BMI >30 kg/m2), WG (n = 508 with normal WG, n = 434 with increased WG), and FM (n = 357) and according to changes in these variables after one year of GH replacement. IGF-1 -, lipid concentrations and QoL using QoL-AGHDA questionnaire were assessed at baseline and after one year of treatment.

Results: At baseline, total and LDL-CH were similarly elevated in the BMI and WG groups, but HDL-cholesterol decreased and triglycerides increased with increasing BMI and WG. QoL was progressively poorer with increasing BMI and WG. After 1 year of GH replacement, total and LDL-cholesterol and QoL improved in all BMI, WG, and FM groups.

Conclusions: Variables of obesity adversely affect the unfavourable lipid profile in GHD subjects by decreasing HDL-cholesterol, but do not counteract the positive effect of GH replacement on LDL-cholesterol. Similarly, QoL is influenced by obesity, but responds equally well to GH treatment independent of BMI, WG, and FM.

European Society of Endocrinology http://www.eje.org/cgi/content/abstract/EJE-08-0448v1