Academic Journal
Overall and cause-specific mortality in GH-deficient adults on GH replacement
| العنوان: | Overall and cause-specific mortality in GH-deficient adults on GH replacement |
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| المؤلفون: | Gaillard, Rolf C, Mattsson, Anders F, Åkerblad, Ann-Charlotte, Bengtsson, Bengt-Åke, Cara, José, Feldt-Rasmussen, Ulla, Kołtowska-Häggström, Maria, Monson, John P, Saller, Bernhard, Wilton, Patrick, Abs, Roger |
| المصدر: | European Journal of Endocrinology ; volume 166, issue 6, page 1069-1077 ; ISSN 0804-4643 1479-683X |
| بيانات النشر: | Oxford University Press (OUP) |
| سنة النشر: | 2012 |
| الوصف: | Objective Hypopituitarism is associated with an increased mortality rate but the reasons underlying this have not been fully elucidated. The purpose of this study was to evaluate mortality and associated factors within a large GH-replaced population of hypopituitary patients. Design In KIMS (Pfizer International Metabolic Database) 13 983 GH-deficient patients with 69 056 patient-years of follow-up were available. Methods This study analysed standardised mortality ratios (SMRs) by Poisson regression. IGF1 SDS was used as an indicator of adequacy of GH replacement. Statistical significance was set to P <0.05. Results All-cause mortality was 13% higher compared with normal population rates (SMR, 1.13; 95% confidence interval, 1.04–1.24). Significant associations were female gender, younger age at follow-up, underlying diagnosis of Cushing's disease, craniopharyngioma and aggressive tumour and presence of diabetes insipidus. After controlling for confounding factors, there were statistically significant negative associations between IGF1 SDS after 1, 2 and 3 years of GH replacement and SMR. For cause-specific mortality there was a negative association between 1-year IGF1 SDS and SMR for deaths from cardiovascular diseases ( P =0.017) and malignancies ( P =0.044). Conclusions GH-replaced patients with hypopituitarism demonstrated a modest increase in mortality rate; this appears lower than that previously published in GH-deficient patients. Factors associated with increased mortality included female gender, younger attained age, aetiology and lower IGF1 SDS during therapy. These data indicate that GH replacement in hypopituitary adults with GH deficiency may be considered a safe treatment. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| DOI: | 10.1530/eje-11-1028 |
| الاتاحة: | http://dx.doi.org/10.1530/eje-11-1028 https://eje.bioscientifica.com/view/journals/eje/166/6/1069.xml |
| رقم الانضمام: | edsbas.656B3C1D |
| قاعدة البيانات: | BASE |
| DOI: | 10.1530/eje-11-1028 |
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