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Analysis of short- and long-term metabolic effects of growth hormone replacement therapy in adult patients with craniopharyngioma and non-functioning pituitary adenoma

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Abstract

Purpose

Adult patients operated for craniopharyngioma develop more frequently GH deficiency (GHD) than patients operated for non-functioning pituitary adenoma (NFPA). The aim of the study was to compare both short- (1 year) and long-term (5 years) effects of rhGH in 38 GHD adult patients (19 operated for Craniopharyngioma (CP) and 19 for NFPA).

Methods

IGF-I levels, body composition (BF %), BMI, lipid profile and glucose homeostasis were evaluated in all patients. Pituitary MRI was performed at baseline and during follow-up, as needed.

Results

At baseline no difference between the two groups was observed, apart from a higher prevalence of diabetes insipidus in CP patients (79 vs 21 %). After 12 months, IGF-I SDS normalized and BF % significantly decreased only in the NFPA group. During long-term treatment, decrease in BF % and improvement in lipid profile shown by reduction in total- and LDL-cholesterol were present in NFPA group only, while increase in insulin levels and HbA1c and decrease of QUICKI were observed in CP patients only. Accordingly, after long-term therapy, the prevalence of metabolic syndrome (MS) was significantly higher in CP than in NFPA group (37 % in CP and in 5 % in NFPA group; p < 0.05).

Conclusion

The present data suggest that CP patients are less sensitive to the positive rhGH effects on lipid profile and BF % and more prone to insulin sensitivity worsening than NFPA patients, resulting in increased prevalence of MS in CP only.

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Acknowledgments

This work was partially supported by Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico.

Conflict of interest

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Authors and Affiliations

  1. Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Endocrinology and Metabolic Diseases Unit, Via Francesco Sforza, 35, 20122, Milan, Italy

    E. Profka, C. Giavoli, S. Bergamaschi, E. Ferrante, E. Malchiodi, E. Sala, E. Verrua, G. Rodari, M. Filopanti, P. Beck-Peccoz & A. Spada

  2. Department of Medical Sciences and Community Health, University of Milan, Milan, Italy

    E. Profka, C. Giavoli, S. Bergamaschi, E. Ferrante, E. Malchiodi, E. Sala, E. Verrua, M. Filopanti, P. Beck-Peccoz & A. Spada

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  1. E. Profka
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  2. C. Giavoli
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Correspondence to E. Profka.

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Profka, E., Giavoli, C., Bergamaschi, S. et al. Analysis of short- and long-term metabolic effects of growth hormone replacement therapy in adult patients with craniopharyngioma and non-functioning pituitary adenoma. J Endocrinol Invest 38, 413–420 (2015). https://doi.org/10.1007/s40618-014-0196-0

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  • DOI: https://doi.org/10.1007/s40618-014-0196-0

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