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The Epidemiology of Growth Hormone Deficiency

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Growth Hormone Related Diseases and Therapy

Part of the book series: Contemporary Endocrinology ((COE))

Abstract

The definition of growth hormone deficiency (GHD) has been disputed for decades. Pituitary disorders or the consequences of the treatment hereof can lead to GHD; however, numerous extrapituitary diseases or syndromes can result in GHD. Guidelines and clarification have been published in order to shed more light on the issue. However, no standardized approach, which can be applied for currently diagnosed persons as well as recently diagnosed persons, exists. When focusing on the diagnosis of GHD, it seems important to differentiate between childhood-onset (CO) and adult-onset (AO) GHD. No arbitrary cut-off age exists, and in the guidelines, this is a clinical definition. Epidemiologically, this is not manageable and often 18 years is used as cut-off age. Data on incidence and prevalence are scarce; however, generally males seem to be diagnosed more often than. Morbidity is increased in patients with GHD; this applies both when focusing on clinical markers and in terms of admissions to hospitals. Similarly, studies from different countries have identified an increased mortality in various subgroups of GHD patients and in total. The increased mortality was especially due to cardiovascular diseases or cancer. The long-term consequences of growth hormone treatment on morbidity and mortality are not fully known; however, the treatment is considered safe except with regard to patients with active malignancy, in whom the treatment is contraindicated.

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References

  1. Juul A, Bernasconi S, Clayton PE, Kiess W, DeMuinck-Keizer SS. European audit of current practice in diagnosis and treatment of childhood growth hormone deficiency. Horm Res. 2002;58(5):233–41.

    Article  PubMed  CAS  Google Scholar 

  2. GH Research Society. Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. J Clin Endocrinol Metab. 2000;85(11):3990–3.

    Article  Google Scholar 

  3. Sonksen PH, Christiansen JS; Growth Hormone Research Society. Consensus guidelines for the diagnosis and treatment of adults with growth hormone deficiency. Growth Horm IGF Res. 1998;8(Suppl B):89–92.

    Google Scholar 

  4. Molitch ME, Clemmons DR, Malozowski S, Merriam GR, Shalet SM, Vance ML. Evaluation and treatment of adult growth hormone deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2006;91(5):1621–34.

    Article  PubMed  CAS  Google Scholar 

  5. Ghigo E, Aimaretti G, Corneli G. Diagnosis of adult GH deficiency. Growth Horm IGF Res. 2008;18(1):1–16.

    Article  PubMed  CAS  Google Scholar 

  6. Ho KKY. Consensus guidelines for the diagnosis and treatment of adults with GH deficiency II: a statement of the GH Research Society in association with the European Society for Pediatric Endocrinology, Lawson Wilkins Society, European Society of Endocrinology, Japan Endocrine Society, and Endocrine Society of Australia. Eur J Endocrinol. 2007;157(6):695–700.

    Article  PubMed  CAS  Google Scholar 

  7. Thomas M, Massa G, Craen M, et al. Prevalence and demographic features of childhood growth hormone deficiency in Belgium during the period 1986-2001. Eur J Endocrinol. 2004;151(1):67–72.

    Article  PubMed  CAS  Google Scholar 

  8. Stochholm K, Gravholt CH, Laursen T, et al. Incidence of GH deficiency – a nationwide study. Eur J Endocrinol. 2006;155:61–71.

    Article  PubMed  CAS  Google Scholar 

  9. Tomlinson JW, Holden N, Hills RK, et al. Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet. 2001;357(9254):425–31.

    Article  PubMed  CAS  Google Scholar 

  10. Halac I, Zimmerman D. Endocrine manifestations of craniopharyngioma. Childs Nerv Syst. 2005;21(8–9):640–8.

    Article  PubMed  Google Scholar 

  11. Littley MD, Shalet SM, Beardwell CG, Ahmed SR, Applegate G, Sutton ML. Hypopituitarism following external radiotherapy for pituitary tumours in adults. Q J Med. 1989;70(262):145–60.

    PubMed  CAS  Google Scholar 

  12. Littley MD, Shalet SM, Beardwell CG, Robinson EL, Sutton ML. Radiation-induced hypopituitarism is dose-dependent. Clin Endocrinol (Oxf). 1989;31(3):363–73.

    Article  CAS  Google Scholar 

  13. Bleyer A. Older adolescents with cancer in North America deficits in outcome and research. Pediatr Clin North Am. 2002;49(5):1027–42.

    Article  PubMed  Google Scholar 

  14. Ghigo E, Masel B, Aimaretti G, et al. Consensus guidelines on screening for hypopituitarism following traumatic brain injury. Brain Inj. 2005;19(9):711–24.

    Article  PubMed  CAS  Google Scholar 

  15. Kelly DF, Gonzalo IT, Cohan P, Berman N, Swerdloff R, Wang C. Hypopituitarism following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a preliminary report. J Neurosurg. 2000;93(5):743–52.

    Article  PubMed  CAS  Google Scholar 

  16. Sheehan H. Postpartum necrosis of the anterior pituitary. J Pathol Bacteriol. 1939;45:189.

    Article  Google Scholar 

  17. Camper SA, Saunders TL, Katz RW, Reeves RH. The Pit-1 transcription factor gene is a candidate for the murine Snell dwarf mutation. Genomics. 1990;8(3):586–90.

    Article  PubMed  CAS  Google Scholar 

  18. Sornson MW, Wu W, Dasen JS, et al. Pituitary lineage determination by the Prophet of Pit-1 homeodomain factor defective in Ames dwarfism. Nature. 1996;384(6607):327–33.

    Article  PubMed  CAS  Google Scholar 

  19. Akinci A, Kanaka C, Eble A, Akar N, Vidinlisan S, Mullis PE. Isolated growth hormone (GH) deficiency type IA associated with a 45-kilobase gene deletion within the human GH gene cluster. J Clin Endocrinol Metab. 1992;75(2):437–41.

    Article  PubMed  CAS  Google Scholar 

  20. Kelberman D, Dattani MT. The role of transcription factors implicated in anterior pituitary development in the aetiology of congenital hypopituitarism. Ann Med. 2006;38(8):560–77.

    Article  PubMed  CAS  Google Scholar 

  21. Hoffman DM, O’Sullivan AJ, Baxter RC, Ho KK. Diagnosis of growth-hormone deficiency in adults. Lancet. 1994;343(8905):1064–8.

    Article  PubMed  CAS  Google Scholar 

  22. Lim YJ, Kwan E, Low LC. Screening test for growth hormone deficiency: usefulness of L-dopa-propranolol provocative test. J Paediatr Child Health. 1994;30(4):328–30.

    Article  PubMed  CAS  Google Scholar 

  23. Gil-Ad I, Topper E, Laron Z. Oral clonidine as a growth hormone stimulation test. Lancet. 1979;2(8154):1242.

    Article  PubMed  CAS  Google Scholar 

  24. Rao RH, Spathis GS. Intramuscular glucagon as a provocative stimulus for the assessment of pituitary function: growth hormone and cortisol responses. Metabolism. 1987;36(7):658–63.

    Article  PubMed  CAS  Google Scholar 

  25. Orme SM, Price A, Weetman AP, Ross RJ. Comparison of the diagnostic utility of the simplified and standard i.m. glucagon stimulation test (IMGST). Clin Endocrinol (Oxf). 1998;49(6):773–8.

    Article  CAS  Google Scholar 

  26. Merimee TJ, Lillicrap DA, Rabinowitz D. Effect of arginine on serum-levels of human growth-hormone. Lancet. 1965;2(7414):668–70.

    Article  PubMed  CAS  Google Scholar 

  27. de San LC, Parkin JM, Turner SJ. Treadmill exercise test in short children. Arch Dis Child. 1984;59(12):1179–82.

    Article  Google Scholar 

  28. Christensen SE, Jorgensen OL, Moller N, Orskov H. Characterization of growth hormone release in response to external heating. Comparison to exercise induced release. Acta Endocrinol (Copenh). 1984;107(3):295–301.

    CAS  Google Scholar 

  29. Rogol AD, Blizzard RM, Johanson AJ, et al. Growth hormone release in response to human pancreatic tumor growth hormone-releasing hormone-40 in children with short stature. J Clin Endocrinol Metab. 1984;59(4):580–6.

    Article  PubMed  CAS  Google Scholar 

  30. Andersen M, Hansen TB, Stoving RK, et al. The pyridostigmine-growth-hormone-releasing-hormone test in adults. The reference interval and a comparison with the insulin tolerance test. Endocrinol Metab. 1996;3(3):197–206.

    CAS  Google Scholar 

  31. Skinner AM, Clayton PE, Price DA, Addison GM, Soo A. Urinary growth hormone excretion in the assessment of children with disorders of growth. Clin Endocrinol (Oxf). 1993;39(2):201–6.

    Article  CAS  Google Scholar 

  32. Liberman B, Cesar FP, Wajchenberg BL. Human growth hormone (hGH) stimulation tests: the sequential exercise and L-dopa procedure. Clin Endocrinol (Oxf). 1979;10(6):649–54.

    Article  CAS  Google Scholar 

  33. Weldon VV, Gupta SK, Klingensmith G, et al. Evaluation of growth hormone release in children using arginine and L-dopa in combination. J Pediatr. 1975;87(4):540–4.

    Article  PubMed  CAS  Google Scholar 

  34. Sizonenko PC, Clayton PE, Cohen P, Hintz RL, Tanaka T, Laron Z. Diagnosis and management of growth hormone deficiency in childhood and adolescence. Part 1: diagnosis of growth hormone deficiency. Growth Horm IGF Res. 2001;11(3):137–65.

    Article  PubMed  CAS  Google Scholar 

  35. Ghigo E, Bellone J, Aimaretti G, et al. Reliability of provocative tests to assess growth hormone secretory status. Study in 472 normally growing children. J Clin Endocrinol Metab. 199;81(9):3323–7.

    Article  Google Scholar 

  36. Rochiccioli P, Enjaume C, Tauber MT, Pienkowski C. Statistical study of 5473 results of nine pharmacological stimulation tests: a proposed weighting index. Acta Paediatr. 1993;82(3):245–8.

    Article  PubMed  CAS  Google Scholar 

  37. Romshe CA, Zipf WB, Miser A, Miser J, Sotos JF, Newton WA. Evaluation of growth hormone release and human growth hormone treatment in children with cranial irradiation-associated short stature. J Pediatr. 1984;104(2):177–81.

    Article  PubMed  CAS  Google Scholar 

  38. Ahmed SR, Shalet SM. Hypothalamic growth hormone releasing factor deficiency following cranial irradiation. Clin Endocrinol (Oxf). 1984;21(5):483–8.

    Article  CAS  Google Scholar 

  39. Chrousos GP, Poplack D, Brown T, O’Neill D, Schwade J, Bercu BB. Effects of cranial radiation on hypothalamic-adenohypophyseal function: abnormal growth hormone secretory dynamics. J Clin Endocrinol Metab. 1982;54(6):1135–9.

    Article  PubMed  CAS  Google Scholar 

  40. Darzy KH, Aimaretti G, Wieringa G, Gattamaneni HR, Ghigo E, Shalet SM. The usefulness of the combined growth hormone (GH)-releasing hormone and arginine stimulation test in the diagnosis of radiation-induced GH deficiency is dependent on the post-irradiation time interval. J Clin Endocrinol Metab. 2003;88(1):95–102.

    Article  PubMed  CAS  Google Scholar 

  41. Clayton PE, Shalet SM. Dose dependency of time of onset of radiation-induced growth hormone deficiency. J Pediatr. 1991;118(2):226–8.

    Article  PubMed  CAS  Google Scholar 

  42. Bjork J, Link K, Erfurth EM. The utility of the growth hormone (GH) releasing hormone-arginine test for diagnosing GH deficiency in adults with childhood acute lymphoblastic leukemia treated with cranial irradiation. J Clin Endocrinol Metab. 2005;90(11):6048–54.

    Article  PubMed  Google Scholar 

  43. Fisker S, Jorgensen JO, Christiansen JS. Variability in growth hormone stimulation tests. Growth Horm IGF Res. 1998;8(Suppl A):31–5.

    Article  PubMed  CAS  Google Scholar 

  44. Fisker S, Jorgensen JO, Orskov H, Christiansen JS. GH stimulation tests: evaluation of GH responses to heat test versus insulin-tolerance test. Eur J Endocrinol. 1998;139(6):605–10.

    Article  PubMed  CAS  Google Scholar 

  45. Badaru A, Wilson DM. Alternatives to growth hormone stimulation testing in children. Trends Endocrinol Metab. 2004;15(6):252–8.

    Article  PubMed  CAS  Google Scholar 

  46. Juul A, Bernasconi S, Chatelain P, et al. Diagnosis of growth hormone (GH) deficiency and the use of GH in children with growth disorders. Horm Res. 1999;51(6):284–99.

    Article  PubMed  CAS  Google Scholar 

  47. Bristow AF. International standards for growth hormone. Horm Res. 1999;51 Suppl 1:7–12.

    Article  PubMed  CAS  Google Scholar 

  48. Burns C, Rigsby P, Moore M, Rafferty B. The First International Standard for Insulin-like Growth Factor-1 (IGF-1) for immunoassay: preparation and calibration in an international collaborative study. Growth Horm IGF Res. 2009;19(5):457–62.

    Article  PubMed  CAS  Google Scholar 

  49. The Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Guidelines for the use of growth hormone in children with short stature. A report by the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. J Pediatr. 1995;127(6):857–67.

    Article  Google Scholar 

  50. Shalet S. Stepping into adulthood: the transition period. Horm Res. 2004;62 Suppl 4:15–22.

    Article  PubMed  CAS  Google Scholar 

  51. Wacharasindhu S, Cotterill AM, Camacho-Hubner C, Besser GM, Savage MO. Normal growth hormone secretion in growth hormone insufficient children retested after completion of linear growth. Clin Endocrinol (Oxf). 1996;45(5):553–6.

    Article  CAS  Google Scholar 

  52. Juul A, Kastrup KW, Pedersen SA, Skakkebak NE. Growth hormone (GH) provocative retesting of 108 young adults with childhood-onset GH deficiency and the diagnostic value of insulin-like growth factor I (IGF-I) and IGF-binding protein-3. J Clin Endocrinol Metab. 1997;82(4):1195–201.

    Article  PubMed  CAS  Google Scholar 

  53. Albertsson-Wikland K, Rosberg S, Karlberg J, Groth T. Analysis of 24-hour growth hormone profiles in healthy boys and girls of normal stature: relation to puberty. J Clin Endocrinol Metab. 1994;78(5):1195–201.

    Article  PubMed  CAS  Google Scholar 

  54. Cacciari E, Tassoni P, Cicognani A, et al. Value and limits of pharmacological and physiological tests to diagnose growth hormone (GH) deficiency and predict therapy response: first and second retesting during replacement therapy of patients defined as GH deficient. J Clin Endocrinol Metab. 1994;79(6):1663–9.

    Article  PubMed  CAS  Google Scholar 

  55. Tauber M, Moulin P, Pienkowski C, Jouret B, Rochiccioli P. Growth hormone (GH) retesting and auxological data in 131 GH-deficient patients after completion of treatment. J Clin Endocrinol Metab. 1997;82(2):352–6.

    Article  PubMed  CAS  Google Scholar 

  56. Gasco V, Corneli G, Beccuti G, et al. Retesting the childhood-onset GH-deficient patient. Eur J Endocrinol. 2008;159 Suppl 1:S45–52.

    Article  PubMed  CAS  Google Scholar 

  57. Marin G, Domene HM, Barnes KM, Blackwell BJ, Cassorla FG, Cutler GB. The effects of estrogen priming and puberty on the growth-hormone response to standardized treadmill exercise and arginine-insulin in normal girls and boys. J Clin Endocrinol Metab. 1994;79(2):537–41.

    Article  PubMed  CAS  Google Scholar 

  58. Wyatt DT, Mark D, Slyper A. Survey of growth hormone treatment practices by 251 pediatric endocrinologists. J Clin Endocrinol Metab. 1995;80(11):3292–7.

    Article  PubMed  CAS  Google Scholar 

  59. Kendall-Taylor P, Jonsson PJ, Abs R, et al. The clinical, metabolic and endocrine features and the quality of life in adults with childhood-onset craniopharyngioma compared with adult-onset craniopharyngioma. Eur J Endocrinol. 2005;152(4):557–67.

    Article  PubMed  CAS  Google Scholar 

  60. Attanasio AF, Lamberts SW, Matranga AM, et al. Adult growth hormone (GH)-deficient patients demonstrate heterogeneity between childhood onset and adult onset before and during human GH treatment. Adult Growth Hormone Deficiency Study Group. J Clin Endocrinol Metab. 1997;82(1):82–8.

    Article  PubMed  CAS  Google Scholar 

  61. Parkin JM. Incidence of growth hormone deficiency. Arch Dis Child. 1974;49(11):904–5.

    Article  PubMed  CAS  Google Scholar 

  62. Vimpani GV, Vimpani AF, Lidgard GP, Cameron EH, Farquhar JW. Prevalence of severe growth hormone deficiency. Br Med J. 1977;2(6084):427–30.

    Article  PubMed  CAS  Google Scholar 

  63. Bao XL, Shi YF, Du YC, Liu R, Deng JY, Gao SM. Prevalence of growth hormone deficiency of children in Beijing. Cochrane Database Syst Rev (Online). 1992;105(5):401–5.

    CAS  Google Scholar 

  64. Lindsay R, Feldkamp M, Harris D, Robertson J, Rallison M. Utah Growth Study: growth standards and the prevalence of growth hormone deficiency. J Pediatr. 1994;125(1):29–35.

    Article  PubMed  CAS  Google Scholar 

  65. Sassolas G, Chazot FB, Jaquet P, et al. GH deficiency in adults: an epidemiological approach. Eur J Endocrinol. 1999;141(6):595–600.

    Article  PubMed  CAS  Google Scholar 

  66. Regal M, Paramo C, Sierra SM, Garcia-Mayor RV. Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain. Clin Endocrinol (Oxf). 2001;55(6):735–40.

    Article  CAS  Google Scholar 

  67. Carroll PV, Christ E, Bengtsson BA, et al.; the members of Growth Hormone Research Society Scientific Committee. Growth hormone deficiency in adulthood and the effects of growth hormone replacement: a review. J Clin Endocrinol Metab. 1998;83(2):382–95.

    Article  Google Scholar 

  68. Hartman ML, Crowe BJ, Biller BM, Ho KK, Clemmons DR, Chipman JJ. Which patients do not require a GH stimulation test for the diagnosis of adult GH deficiency? J Clin Endocrinol Metab. 2002;87(2):477–85.

    Article  PubMed  CAS  Google Scholar 

  69. Toogood AA, Beardwell CG, Shalet SM. The severity of growth hormone deficiency in adults with pituitary disease is related to the degree of hypopituitarism. Clin Endocrinol (Oxf). 1994;41(4):511–6.

    Article  CAS  Google Scholar 

  70. Bulow B, Hagmar L, Eskilsson J, Erfurth EM. Hypopituitary females have a high incidence of cardiovascular morbidity and an increased prevalence of cardiovascular risk factors. J Clin Endocrinol Metab. 2000;85(2):574–84.

    Article  PubMed  CAS  Google Scholar 

  71. Colao A, Di Somma C, Salerno M, Spinelli L, Orio F, Lombardi G. The cardiovascular risk of GH-deficient adolescents. J Clin Endocrinol Metab. 2002;87(8):3650–5.

    Article  PubMed  CAS  Google Scholar 

  72. Jorgensen JO, Pedersen SA, Thuesen L, et al. Beneficial effects of growth hormone treatment in GH-deficient adults. Lancet. 1989;1(8649):1221–5.

    Article  PubMed  CAS  Google Scholar 

  73. Salomon F, Cuneo RC, Hesp R, Sonksen PH. The effects of treatment with recombinant human growth-hormone on body-composition and metabolism in adults with growth-hormone deficiency. N Engl J Med. 1989;321(26):1797–803.

    Article  PubMed  CAS  Google Scholar 

  74. Lucidi P, Lauteri M, Laureti S, et al. A dose-response study of growth hormone (GH) replacement on whole body protein and lipid kinetics in GH-deficient adults. J Clin Endocrinol Metab. 1998;83(2):353–7.

    Article  PubMed  CAS  Google Scholar 

  75. de Boer H, Blok GJ, van Lingen A, Teule GJ, Lips P, van der Veen EA. Consequences of childhood-onset growth hormone deficiency for adult bone mass. J Bone Miner Res. 1994;9(8):1319–26.

    Article  PubMed  Google Scholar 

  76. Hyer SL, Rodin DA, Tobias JH, Leiper A, Nussey SS. Growth hormone deficiency during puberty reduces adult bone mineral density. Arch Dis Child. 1992;67(12):1472–4.

    Article  PubMed  CAS  Google Scholar 

  77. Rosen T, Wilhelmsen L, Landin-Wilhelmsen K, Lappas G, Bengtsson BA. Increased fracture frequency in adult patients with hypopituitarism and GH deficiency. Eur J Endocrinol. 1997;137(3):240–5.

    Article  PubMed  CAS  Google Scholar 

  78. Murray RD, Brennan BM, Rahim A, Shalet SM. Survivors of childhood cancer: long-term endocrine and metabolic problems dwarf the growth disturbance. Acta Paediatr Suppl. 1999;88(433):5–12.

    Article  PubMed  CAS  Google Scholar 

  79. Stochholm K, Laursen T, Green A, et al. Morbidity and GH deficiency: a nationwide study. Eur J Endocrinol. 2008;158(4):447–57.

    Article  PubMed  CAS  Google Scholar 

  80. Swerdlow AJ, Higgins CD, Adlard P, Preece MA. Risk of cancer in patients treated with human pituitary growth hormone in the UK, 1959-85: a cohort study. Lancet. 2002;360(9329):273–7.

    Article  PubMed  CAS  Google Scholar 

  81. Fradkin JE, Mills JL, Schonberger LB, et al. Risk of leukemia after treatment with pituitary growth hormone. JAMA. 1993;270(23):2829–32.

    Article  PubMed  CAS  Google Scholar 

  82. Sklar CA, Mertens AC, Mitby P, et al. Risk of disease recurrence and second neoplasms in survivors of childhood cancer treated with growth hormone: a report from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab. 2002;87(7):3136–41.

    Article  PubMed  CAS  Google Scholar 

  83. Swerdlow AJ, Reddingius RE, Higgins CD, et al. Growth hormone treatment of children with brain tumors and risk of tumor recurrence. J Clin Endocrinol Metab. 2000;85(12):4444–9.

    Article  PubMed  CAS  Google Scholar 

  84. Mills JL, Schonberger LB, Wysowski DK, et al. Long-term mortality in the United States cohort of pituitary-derived growth hormone recipients. J Pediatr. 2004;144(4):430–6.

    Article  PubMed  CAS  Google Scholar 

  85. Tuffli GA, Johanson A, Rundle AC, Allen DB. Lack of increased risk for extracranial, nonleukemic neoplasms in recipients of recombinant deoxyribonucleic acid growth hormone. J Clin Endocrinol Metab. 1995;80(4):1416–22.

    Article  PubMed  CAS  Google Scholar 

  86. Svensson J, Bengtsson BA, Rosen T, Oden A, Johannsson G. Malignant disease and cardiovascular morbidity in hypopituitary adults with or without growth hormone replacement therapy. J Clin Endocrinol Metab. 2004;89(7):3306–12.

    Article  PubMed  CAS  Google Scholar 

  87. Stochholm K, Gravholt CH, Laursen T, et al. Mortality in growth hormone deficiency – a nationwide study. Eur J Endocrinol. 2007;157:9–18.

    Article  PubMed  CAS  Google Scholar 

  88. Taback SP, Dean HJ. Mortality in Canadian children with growth hormone (GH) deficiency receiving GH therapy 1967-1992. The Canadian Growth Hormone Advisory Committee. J Clin Endocrinol Metab. 1996;81(5):1693–6.

    Article  PubMed  CAS  Google Scholar 

  89. Rosen T, Bengtsson BA. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet. 1990;336(8710):285–8.

    Article  PubMed  CAS  Google Scholar 

  90. Bates AS, Van’t Hoff W, Jones PJ, Clayton RN, et al. The effect of hypopituitarism on life expectancy. J Clin Endocrinol Metab. 1996;81(3):1169–72.

    Article  PubMed  CAS  Google Scholar 

  91. Bulow B, Hagmar L, Mikoczy Z, Nordstrom CH, Erfurth EM. Increased cerebrovascular mortality in patients with hypopituitarism. Clin Endocrinol (Oxf). 1997;46(1):75–81.

    Article  CAS  Google Scholar 

  92. Bates AS, Bullivant B, Sheppard MC, Stewart PM. Life expectancy following surgery for pituitay tumours. Clin Endocrinol (Oxf). 1999;50(1999):315–9.

    Article  CAS  Google Scholar 

  93. Besson A, Salemi S, Gallati S, et al. Reduced longevity in untreated patients with isolated growth hormone deficiency. J Clin Endocrinol Metab. 2003;88(8):3664–7.

    Article  PubMed  CAS  Google Scholar 

  94. Erfurth EM, Bulow B, Svahn-Tapper G, et al. Risk factors for cerebrovascular deaths in patients operated and irradiated for pituitary tumors. J Clin Endocrinol Metab. 2002;87(11):4892–9.

    Article  PubMed  CAS  Google Scholar 

  95. Nilsson B, Gustavsson-Kadaka E, Bengtsson BA, Jonsson B. Pituitary adenomas in Sweden between 1958 and 1991: incidence, survival, and mortality. J Clin Endocrinol Metab. 2000;85(4):1420–5.

    Article  PubMed  CAS  Google Scholar 

  96. Lindholm J, Nielsen EH, Bjerre P, et al. Hypopituitarism and mortality in pituitary adenoma. Clin Endocrinol (Oxf). 2006;65(1):51–8.

    Article  CAS  Google Scholar 

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Stochholm, K., Christiansen, J.S. (2011). The Epidemiology of Growth Hormone Deficiency. In: Ho, K. (eds) Growth Hormone Related Diseases and Therapy. Contemporary Endocrinology. Humana Press. https://doi.org/10.1007/978-1-60761-317-6_8

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