Klinische Wochenschrift

, Volume 69, Issue 16, pp 769–773

Erhöhte Prävalenz von Osteoporose und Arteriosklerose bei konventionell substituierter Hypophysenvorderlappeninsuffizienz: Bedarf einer zusätzlichen Wachstumshormonsubstitution?

  • C. Wüster
  • E. Slenczka
  • R. Ziegler
Originalien

Abkürzungen

STH

Wachstumshormon

HVL

Hypophysenvorderlappen

PROCAM

Prospektive Cardiovaskuläre Münster Studie (1)

TRH

Thyreotropin releasing hormone

TSH

Thyreoidea stimulierendes Hormon

LHRH

Luteinisierendes hormone releasing hormone

EKG

Elektrokardiogramm

DPA

Dual-Photonen-Absorptiometrie

SPAD

Single-Photonen-Absorptiometrie, distaler Unterarm

SPAP

dito, proximaler Unterarm

Increased prevalence of osteoporosis and arteriosclerosis in patients with conventionally substituted pituitary insufficiency: Is there a need for additional growth hormone substitution?

Summary

In a retrospective study of 632 patients with pituitary disease we diagnosed pituitary insufficiency without hypersecretion of any pituitary hormone in 122 patients. Patients were substituted with sex hormones (76%), hydrocortisone (74%) and/or L-thyroxine (77%). 76% had additional growth hormone deficiency, as shown by an increase of growth hormone of less than 5 ng/ml after i.v. administration of L-arginine. In 17% of all patients the diagnosis of osteoporosis was proven or suspected radiologically. 57% had low bone mass of lumbar spine (dualphotonabsorptiometry) and 73% had low bone mass of the proximal forearm (singlephotonabsorptiometry). BMD values of pituitary insufficient patients were in the same range as those of patients with established osteoporosis.

More than half of all patients (53%) complained of tiredness, exhaustion and muscle weakness. 40% suffered from adipositas. 77% had hyperlipidemia (68% hypertriglyceridemia and 42% hypercholesterinemia), 18% had hypertension. 14% of the patients had arteriosclerotic events in their history (myocardial infarction or stroke). These figures are higher than incidences shown in the German PROCAM-study. These data show an increased prevalence of osteoporosis and vascular diseases. This is in contrast to the general opinion, that patients with pituitary insufficiency are adequately treated by substitution with adrenal, thyroid and sex hormones. Whether other factors such as the additional growth hormone deficiency are responsible for these diseases has to be examined in prospective studies.

Key words

Pituitary insufficiency Osteoporosis Bone mineral density Arteriosclerosis Hyperlipidemia Growth hormone deficiency 

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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • C. Wüster
    • 1
  • E. Slenczka
    • 1
  • R. Ziegler
    • 1
  1. 1.Abteilung Innere Medizin I, Endokrinologie und StoffwechselUniversität HeidelbergDeutschland

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