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Morbidity and GH deficiency: a nationwide study.

Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital, Aarhus Sygehus, NBG, DK-8000 Aarhus C, Denmark¹ Department of Pharmacology, University of Aarhus, 8000 Aarhus C, Denmark² Department of Applied Research and HTA, Odense University Hospital, 5000 Odense C, Denmark³ Institute of Public Health, University of Southern Denmark, 5000 Odense C, Denmark⁴ Department of Endocrinology, Aalborg University Hospital, 9100 Aalborg, Denmark⁵ Department of Endocrinology, Odense University Hospital, 5000 Odense C, Denmark⁶ Department of Endocrinology, Herlev University Hospital, 2730 Herlev, Denmark⁷ Department of Endocrinology PE, Rigshospitalet, 2100 Copenhagen, Denmark⁸ Department of Biostatistics, University of Aarhus, 8000 Aarhus C, Denmark

(Correspondence should be addressed to K Stochholm; Email: stochholm{at}dadlnet.dk)

Objective: To estimate morbidity in Denmark in all patients with GH deficiency (GHD).

Design: Morbidity was analyzed in 1794 GHD patients and 8014 controls matched on age and gender. All records in the GHD patients were studied and additional morbidity noted. Diagnoses and dates of admissions were identified in the National Patient Registry. Lag time until first admission was used as a measure of morbidity. Patients were divided into childhood onset (CO) and adult onset (AO), discriminated by an age cut-off of 18 years at onset of GHD.

Method: Sex- and cause-specific hazard ratios (HRs) in CO and AO GHD compared with controls.

Results: Total morbidity was significantly increased in the GHD patients. HR for CO males: 3.1 (95% confidence interval (CI): 2.7–3.7), CO females: 3.2 (95% CI: 2.6–3.9), AO males: 2.9 (95% CI: 2.6–3.2), and AO females: 3.2 (95% CI: 2.8–3.6). In 18 out of 20 chapters from the International Classification of Diseases-10, a significantly increased morbidity was identified for at least one of the four subgroups of patients. Morbidity was significantly increased in all the four subgroups due to infectious, endocrine, pulmonary, urogenital, and neurological diseases; cancer; diseases of the eye, ear, and circulatory diseases; and traumas. Fractures were significantly increased in AO females, not in males.

Conclusions: Morbidity was significantly increased in the GHD patients. The increased morbidity was due to a variety of disorders, some of which can readily be explained by GHD and other pituitary deficiencies, while others cannot be easily explained.