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Special features on insulin resistance, metabolic syndrome and vascular complications in hypopituitary patients

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Abstract

Pituitary hormone deficiency, hypopituitarism, is a dysfunction resulting from numerous etiologies, which can be complete or partial, and is therefore heterogeneous. This heterogeneity makes it difficult to interpret the results of scientific studies with these patients.

Adequate treatment of etiologies and up-to-date hormone replacement have improved morbidity and mortality rates in patients with hypopituitarism. As GH replacement is not performed in a reasonable proportion of patients, especially in some countries, it is essential to understand the known consequences of GH replacement in each subgroup of patients with this heterogeneous dysfunction.

In this review on hypopituitarism, we will address some particularities regarding insulin resistance, which is no longer common in these patients with hormone replacement therapy based on current guidelines, metabolic syndrome and its relationship with changes in BMI and body composition, and to vascular complications that need to be prevented taking into account the individual characteristics of each case to reduce mortality rates in these patients.

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Data availability statement

N/A All data in this review are in the respective publications.

Abbreviations

ACTH:

Adrenocorticotrophic Hormone

AOGHD:

Adulthood-onset Growth Hormone Deficiency

CVD:

Cardiovascular Disease

COGHD:

Childhood-onset Growth Hormone Deficiency

EHC:

Euglycemic Hyperinsulinemic Clamp

aGHD:

adult patient with Growth Hormone Deficiency

BMI:

Body Mass Index

GH:

Growth Hormone

GHD:

Growth Hormone Deficiency

GHRH:

Growth Hormone Release Hormone

GHRT:

Growth Hormone Replacement Therapy

GTT:

Glucose Tolerance Test

HOMA:

Homeostatic Model Assessment

HP:

Hypopituitarism

IGF:

Insulin Growth Factor

IGFBP:

Insulin Growth Factor Binding Protein

IGFR:

Insulin Growth Factor Receptor

IS:

Insulin Sensitivity

IR:

Insulin Resistance

Kda:

Kilodalton

MetS:

Metabolic Syndrome

WHO:

World Health Organization

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    Heraldo M Garmes

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Garmes, H.M. Special features on insulin resistance, metabolic syndrome and vascular complications in hypopituitary patients. Rev Endocr Metab Disord (2024). https://doi.org/10.1007/s11154-023-09872-8

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