Resumen

FIDELEFF, Hugo L.  y  KIMS. Argentine Group et al. Medium and long term outcome of growth hormone therapy in growth hormone deficient adults. Medicina (B. Aires) [online]. 2006, vol.66, n.4, pp.296-302. ISSN 0025-7680.

We evaluated long-term replacement therapy outcomes in various subsets of patients with adult growth hormone (GH) deficiency (AGHD) as well as the patients' susceptibility to adverse events. Fifty-nine patients with AGHD were evaluated, 27 with childhood onset (CO) (18-44 years old, 12 females) and 32 with adult onset (AO) (27-70 years, 18 females). A significant improvement in HDL-cholesterol was observed in AGHD-AO males (basal: 41.3 ± 12.9 mg/dl, intratreatment: 47.5 ± 13.2 mg/dl, p= 0.009). However, individual analyses showed that total cholesterol decreased below 240 mg/dl in 33% of AGHD-CO patients and in 50% of AGHD-AO patients, and below 200 mg/dl in 67% of AGHD-CO patients and in 29% of AGHD-AO patients;  in the AGHD-AO group, normalization of LDL-cholesterol (£ 160 mg/dl) and triglycerides (£ 200 mg/dl) was found in 100% and 50% of patients, respectively; the total cholesterol/HDL ratio decreased below 4.5 in 20% of AGHD-CO patients and in 25% of AGHD-AO patients. The cardiological evaluation showed a significant intra- and interindividual heterogeneity, but cardiac mass improved in patients with a baseline cardiac mass index below 60 g/m². Markers of bone apposition increased significantly, while bone resorption markers were found to remain unchanged during treatment. A correlation was found between increased bone mineral content and lean body mass (p= 0.0009). Susceptibility to adverse events was not found to be dependent on gender or on the time of onset of the deficiency. Our findings would appear to confirm that a more severe metabolic impairment is correlated with a better therapeutic outcome.

Palabras clave : Growth hormone; Adult growth hormone deficiency; Metabolic alterations; Growth hormone treatment.

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