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

¹ Department of Endocrinology, University of Antwerp, 2560 Antwerp, Belgium² Department of Endocrinology, St Augustine and St Vincent Hospital, 2610 Antwerp, Belgium³ Department of Endocrinology, Hospital T Alvarez, Buenos Aires, Argentina⁴ Department of Endocrinology, National University Hospital, Copenhagen, Denmark⁵ Department of Endocrinology, KIMS Medical Outcomes, Pfizer Endocrine Care, Sollentuna, Sweden⁶ Department of Pharmacy, Uppsala University, Uppsala, Sweden⁷ KIGS-KIMS-ACROSTUDY Medical Outcomes, Pfizer Endocrine Care, New York, New York, USA

(Correspondence should be addressed to P Abrams who is now at Universiteitsplein, B-2610 Wilrijk, Belgium; Email: pascale.abrams{at}belgacom.net)

Objective: GH 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 brought about by 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 1 year of GH replacement. Serum IGF-I concentrations, lipid concentrations and QoL using the QoL Assessment of GHD in Adults questionnaire were assessed at baseline and after 1 year of treatment.

Results: At baseline, total and low-density lipoprotein (LDL) cholesterol were similarly elevated in the BMI and WG groups, but high-density lipoprotein (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 already 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.

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				M. Koltowska-Haggstrom, A. F Mattsson, and S. M Shalet Assessment of quality of life in adult patients with GH deficiency: KIMS contribution to clinical practice and pharmacoeconomic evaluations Eur. J. Endocrinol., November 1, 2009; 161(suppl_1): S51 - S64. [Abstract] [Full Text] [PDF]