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- Title
Comorbidity and cardiovascular risk factors in adult GH deficiency following treatment for Cushing's disease or non-functioning pituitary adenomas during childhood.
- Authors
Ragnarsson, Oskar; Höybye, Charlotte; Jönsson, Peter J.; Feldt-Rasmussen, Ulla; Johannsson, Gudmundur; Biller, Beverly M. K.; Kołtowska-Häggström, Maria
- Abstract
Objective: Cushing's disease (CD) and non-functioning pituitary adenoma (NFPA) are rare in paediatric patients. The aim of this study was to describe long-term consequences in adults with GH deficiency (GHD) treated for CD or NFPA during childhood. Design, patients and methods: This was a retrospective analysis of data from KIMS (Pfizer International Metabolic Database). Background characteristics, anthropometry and comorbidity were studied in 47 patients diagnosed with childhood-onset (CO)-CD and 62 patients with CO-NFPA. Data from 100 ACTH-sufficient patients with CO-idiopathic hypopituitarism (CO-Idio) were used for comparison. Cardiovascular risk profile was analysed at baseline and at 1 year on GH treatment in a subgroup of patients (17 CO-CD, 24 CO-NFPA and 55 CO-Idio) not receiving GH treatment at study entry. Results: The median age at diagnosis of pituitary tumour was 14.0 years (range 10-17) in patients with CO-CD and 13.7 years (range 8-17) in CO-NFPA. In addition to GHD, 41% of patients with CO-CD had three or four other pituitary hormone deficiencies compared with 78% of patients with CO-NFPA (P<0.001). Eighty-nine per cent of patients with CO-CD had height SDS lower than 0 compared with 61% of patients with CO-NFPA (P=0.002). Hypertension was more common in CO-CD compared with CO-Idio (23 vs 9%, P=0.018). At 1 year on GH treatment, total- and low-density lipoproteincholesterol decreased significantly in CO-CD but not in CO-NFPA. Conclusion: Adult patients with GHD following treatment for paediatric CD and NFPA have long-term adverse consequences. Despite more severe hypopituitarism in CO-NFPA, patients with CO-CD have more frequently compromised final stature.
- Subjects
CARDIOVASCULAR diseases risk factors; CUSHING'S syndrome treatment; PITUITARY tumors; CHILDHOOD cancer; RETROSPECTIVE studies; ANTHROPOMETRY; HYPOPITUITARISM; DIAGNOSIS
- Publication
European Journal of Endocrinology, 2012, Vol 166, Issue 4, p593
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-11-0942