Hypercholesterolemia and Obesity in Adult Patients with Hypopituitarism: A Report of a Nation-wide Survey in Japan

Murakami, Yoshio; Kato, Yuzuru

doi:10.1507/endocrj.50.759

Cited by 12 publications

(13 citation statements)

References 30 publications

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“…The higher prevalence of obesity was in good agreement with a previous report [11]. It is likely that the result is secondary to an excess food intake from hypothalamic dysfunction supposed to be more frequent in such patients.…”

Section: Discussionsupporting

confidence: 92%

“…In our previous study of similar subjects using univariate analysis, serum total cholesterol levels only in men were significantly higher in GHD than in non-GHD, but the prevalence of hypercholesterolemia was not significantly different between GHD and non-GHD both in men and women [4]. Therefore, this finding was not only consistent with our previous report that cardiovascular disease in adult GHD was less prevalent than expected in Japan [4] but also with others report that there was no association between GHD and either hypercholesterolemia [11,16,17] or obesity [11]. On the other hand, some investigators reported the increased total cholesterol levels in GHD [18][19][20].…”

Section: Discussionsupporting

confidence: 90%

“…It is likely that GHD is a factor for a prevalence of vascular risk factors in hypopituitary adults with GHD. However, it is still controversial whether only GHD is a contributing factor for increased cardiovascular risk or death in adult hypopituitarism [3,11,14,15]. In this report, we have examined the influence of GHD without replacement on a prevalence of vascular risk disorders.…”

Section: Discussionmentioning

confidence: 99%

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Hormone Replacement Therapy and Vascular Risk Disorders in Adult Hypopituitarism

et al. 2007

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Abstract. Adult patients with hypopituitarism are treated by the replacement of deficient hormones, although GH has not been substituted until March 2006 in Japan except for clinical trial. This study examines which hormonal status influences the prevalence of vascular risk disorders in hypopituitary adults. A sample of 263 adult patients with hypopituitarism was studied, among whom there were various hormonal status such as no deficiency, treated or untreated deficiency of each pituitary hormone. Analysis of adult patients with hypopituitarism showed that hypertension was more prevalent in the older than in younger patients and in male than in female patients. Hypercholesterolemia and hypertriglyceridemia were more prevalent in patients with TSH deficiency even with thyroxine substitution than those without TSH deficiency. Both obesity and hypertension were less prevalent in patients with treated ACTH deficiency than those without ACTH deficiency. Obesity was more prevalent in patients with treated vasopressin deficiency than those without vasopressin deficiency. These results provide evidence that glucocorticoid substitution in ACTH deficient adults was favorable to prevent obesity and hypertension but that the thyroxine substitution in TSH deficient adults appeared rather insufficient to prevent hyperlipidemia.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Hormone Replacement Therapy and Vascular Risk Disorders in Adult Hypopituitarism

et al. 2007

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“…Epidemiological studies have shown that this abdominal obesity is a risk factor for development of metabolic abnormalities leading to cardiovascular complications [4,5]. In studies in Japanese adult patients with GHD it has been shown that there is an increased risk of cardio-and cerebro-vascular morbidity and mortality compared to the normal population [6][7][8], similar to that previously shown in Caucasian patients [5,[9][10][11].…”

supporting

confidence: 65%

Growth Hormone (GH) Effects on Central Fat Accumulation in Adult Japanese GH Deficient Patients: 6-month Fixed-dose Effects Persist during Second 6-month Individualized-dose Phase

et al. 2006

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Abstract. Both Japanese and Caucasian adults with GH deficiency (GHD) have pronounced abdominal obesity, which is associated with increased risk of cardiovascular complications. We investigated the effects of GH treatment in 27 adult Japanese GHD patients, 15 with adult onset (AO) and 12 with childhood onset (CO) GHD. Patients initially received GH titrated to 0.012 mg/kg/day for 24 weeks in a double-blind design and the dose was then individualized for each patient according to IGF-I for a further 24 weeks. Dual-energy x-ray absorptiometry (DXA) data were evaluated for percentages of trunk fat, total body fat and lean body mass. Serum IGF-I and lipid concentrations were determined at a central laboratory. There were 25 patients who completed 48 weeks of treatment, with 7, 6 and 12 patients then receiving GH at 0.003, 0.006 and 0.012 mg/kg/day, respectively. With the reductions in dose when individualized between weeks 24 and 48, mean serum IGF-I level was reduced and excessively high values, observed in AO patients on the fixed GH dose, were no longer seen. The decrease from baseline in trunk fat was similar at week 24 (-3.8 ± 3.3%, p<0.001) and week 48 (-3.1 ± 3.7%, p<0.001), and the difference between changes was not significant. Total cholesterol was decreased from baseline by -24 ± 28 mg/dl (p<0.001) at week 24 and -17 ± 28 mg/dl (p = 0.007) at week 48. Two patients had elevated HbA1c levels: one continued GH treatment after a dose reduction and the other discontinued due to persistent impaired glucose tolerance. Therefore, excessively high IGF-I levels can be avoided by individualized dosing during long-term GH treatment. Individualized dosing maintains the decrease in abdominal fat in adult Japanese GHD patients and should reduce the cardiovascular risk.

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“…About 30% of the subjects in the present study had a total cholesterol value higher than the Framingham threshold for cardiovascular risk; this would indicate an approximately fourfold increase in risk compared with the general population and confirms our interpretation of the BMI and FM data. High total cholesterol concentrations were reported for hypopituitary patients in a national survey in Japan (18). However, it was reported that the hypercholesterolaemia was associated with untreated gonadotrophin and thyrotrophin deficiencies and not with GHD.…”

Section: Ao Patients Co Patientsmentioning

confidence: 96%

Adult GH deficiency in Japanese patients: effects of GH treatment in a randomised, placebo-controlled trial

Chihara

Koledova²,

Shimatsu³

et al. 2004

European Journal of Endocrinology

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Objective: To evaluate the influence of factors intrinsic to the Japanese population on consequences of growth hormone deficiency (GHD) and effects of GH treatment in adult Japanese hypopituitary patients with GHD. Study design: A 24-week, randomised, placebo-controlled, double-blind study in 64 patients in Japan, with GHD onset during adulthood (AO; n ¼ 27) or childhood (CO; n ¼ 37). Body composition measured by dual-energy X-ray absorptiometry (DXA) was evaluated centrally. Serum IGF-I, IGF binding protein-3 (IGFBP-3) and lipid levels were determined centrally. Results: In contrast to Caucasian patients, there were no significant differences before treatment between AO and CO patients for body mass index (BMI), lean body mass (LBM) and fat mass (FM). Baseline BMI was $ 25 kg/m 2 for 32.8% of patients. For all patients combined, a significant increase in LBM and decrease in FM (P , 0.001 for each) was seen with GH treatment. Serum IGF-I and IGFBP-3 were significantly lower at baseline in CO compared with AO patients, similar to Caucasian patients, and were increased in both onsets following GH treatment. Serum total and low-density lipoprotein (LDL)-cholesterol concentrations did not differ between AO and CO patients at baseline and were elevated compared with normal ranges. GH-induced decreases were significant compared with placebo for both total (P ¼ 0.036) and LDL-cholesterol (P ¼ 0.040). Glycosylated haemoglobin was increased with GH compared with placebo treatment (P ¼ 0.016) but remained within the upper limit of normal for all patients at endpoint. Conclusions: Adult Japanese hypopituitary patients with GHD demonstrated obesity relative to healthy Japanese subjects but the clinical presentation differed from that of Caucasian patients. GH treatment improved body composition and serum cholesterol profiles of adult Japanese hypopituitary patients with GHD. European Journal of Endocrinology 151 343-350

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Hypercholesterolemia and Obesity in Adult Patients with Hypopituitarism: A Report of a Nation-wide Survey in Japan

Cited by 12 publications

References 30 publications

Hormone Replacement Therapy and Vascular Risk Disorders in Adult Hypopituitarism

Hormone Replacement Therapy and Vascular Risk Disorders in Adult Hypopituitarism

Growth Hormone (GH) Effects on Central Fat Accumulation in Adult Japanese GH Deficient Patients: 6-month Fixed-dose Effects Persist during Second 6-month Individualized-dose Phase

Adult GH deficiency in Japanese patients: effects of GH treatment in a randomised, placebo-controlled trial

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