%0 Journal Article
%T Medium and long term outcome of growth hormone therapy in growth hormone deficient adults Resultados en el mediano y largo plazo del tratamiento con hormona de crecimiento en adultos deficitarios de dicha hormona
%A Hugo L. Fideleff
%A Hugo Boquete
%A Ana Giaccio
%A Patricia Sobrado
%J Medicina (Buenos Aires)
%D 2006
%I Fundaci車n Revista Medicina
%X 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. Evaluamos resultados terap谷uticos a largo plazo en subgrupos de pacientes con deficiencia de hormona de crecimiento (GH) del adulto (AGHD) y la susceptibilidad para desarrollar eventos adversos. Estudiamos 59 pacientes con AGHD, 27 de inicio en la infancia (CO) (18-44 a os, 12 mujeres) y 32 de inicio en la adultez (AO) (27-70 a os, 18 mujeres). El HDL-colesterol mejor車 significativamente en varones AGHD-AO (basal: 41.3 ㊣ 12.9 mg/dl, intratratamiento: 47.5 ㊣ 13.2 mg/dl, p= 0.009). El an芍lisis individual mostr車 que el colesterol total descendi車 por debajo de 240 mg/dl en el 33% de los AGHD-CO y en el 50% de los AGHD-AO, y por debajo de 200 mg/dl en el 67% de los pacientes AGHD-CO y en el 29% de los AGHD-AO; en el grupo AGHD-AO, se normaliz車 el LDL-colesterol (㏒ 160 mg/dl) y los triglic谷ridos (㏒ 200 mg/dl) en el 100% y 50% de los pacientes respectivamente; el 赤ndice colesterol total /HDL disminuy車 por debajo de 4.5 en el 20% de los pacientes AGHD-CO y
%K Hormona de crecimiento
%K Deficiencia de hormona de crecimiento del adulto
%K Alteraciones metab車licas
%K Tratamiento con hormona de crecimiento
%K Growth hormone
%K Adult growth hormone deficiency
%K Metabolic alterations
%K Growth hormone treatment
%U http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802006000400002