Changing patterns of the adult growth hormone deficiency diagnosis documented in a decade-long global surveillance database
(2009) In The Journal of clinical endocrinology and metabolism 94(2). p.9-392- Abstract
BACKGROUND: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, and the indication has subsequently gained broad acceptance. The HypoCCS surveillance database is a suitable means to examine the evolution of diagnostic patterns since 1996.
METHODS: Baseline demographics, reported cause of GHD, and diagnostic tests were available from 5893 GH-treated patients. Trends for change over time in diagnosis, GH stimulation test data, and IGF-I measurements were analyzed at 2-yr intervals by linear regression models, with entry year as the predictive variable.
RESULTS: Over the decade, there was a decrease in patients enrolled with diagnoses of pituitary adenoma (50.2 to 38.6%; P < 0.001),... (More)
BACKGROUND: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, and the indication has subsequently gained broad acceptance. The HypoCCS surveillance database is a suitable means to examine the evolution of diagnostic patterns since 1996.
METHODS: Baseline demographics, reported cause of GHD, and diagnostic tests were available from 5893 GH-treated patients. Trends for change over time in diagnosis, GH stimulation test data, and IGF-I measurements were analyzed at 2-yr intervals by linear regression models, with entry year as the predictive variable.
RESULTS: Over the decade, there was a decrease in patients enrolled with diagnoses of pituitary adenoma (50.2 to 38.6%; P < 0.001), craniopharyngioma (13.3 to 8.4%; P = 0.005) and pituitary hemorrhage (5.8 to 2.8%; P = 0.001); increases in idiopathic GHD (13.9 to 19.3%; P < 0.001), less common diagnoses (7.4 to 15.8%; P < 0.001), and undefined/unknown diagnoses (1.3 to 8.6%; P < 0.001) were observed. Use of arginine, clonidine, and L-dopa tests declined, whereas use of the GHRH-arginine test increased. Median values for peak GH from all tests except GHRH-arginine and for IGF-I SD scores increased significantly (P < 0.001). Over the decade (1996--2005), idiopathic GHD was reported for 16.7% of patients, and more than half of these had adult onset GHD. In the idiopathic adult onset group, 40.2% had isolated GHD; 18.3 and 4.4% had a stimulation test GH peak of at least 3.0 and 5.0 microg/liter, respectively.
CONCLUSIONS: Significant shifts in diagnostic patterns have occurred since approval of the adult GHD indication, with a trend to less severe forms of GHD.
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- author
- Webb, Susan M ; Strasburger, Christian J ; Mo, Daojun ; Hartman, Mark L ; Melmed, Shlomo ; Jung, Heike ; Blum, Werner F and Attanasio, Andrea F
- contributor
- Erfurth, Eva Marie LU
- author collaboration
- publishing date
- 2009-02
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Age of Onset, Arginine/analysis, Databases, Factual, Diagnostic Techniques, Endocrine/trends, Female, Growth Disorders/classification, Growth Hormone-Releasing Hormone/analysis, Human Growth Hormone/deficiency, Humans, Insulin Resistance/physiology, Male, Middle Aged, Pituitary Diseases/complications, Population Surveillance/methods, Professional Practice/trends
- in
- The Journal of clinical endocrinology and metabolism
- volume
- 94
- issue
- 2
- pages
- 8 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:59849107735
- pmid:19001512
- ISSN
- 0021-972X
- DOI
- 10.1210/jc.2008-0713
- language
- English
- LU publication?
- no
- id
- 48988d45-632c-49eb-af93-69b80aa6f018
- date added to LUP
- 2023-11-17 09:28:36
- date last changed
- 2024-03-02 10:14:58
@article{48988d45-632c-49eb-af93-69b80aa6f018,
abstract = {{<p>BACKGROUND: GH therapy in adult patients with GH deficiency (GHD) was approved over 10 yr ago, and the indication has subsequently gained broad acceptance. The HypoCCS surveillance database is a suitable means to examine the evolution of diagnostic patterns since 1996.</p><p>METHODS: Baseline demographics, reported cause of GHD, and diagnostic tests were available from 5893 GH-treated patients. Trends for change over time in diagnosis, GH stimulation test data, and IGF-I measurements were analyzed at 2-yr intervals by linear regression models, with entry year as the predictive variable.</p><p>RESULTS: Over the decade, there was a decrease in patients enrolled with diagnoses of pituitary adenoma (50.2 to 38.6%; P < 0.001), craniopharyngioma (13.3 to 8.4%; P = 0.005) and pituitary hemorrhage (5.8 to 2.8%; P = 0.001); increases in idiopathic GHD (13.9 to 19.3%; P < 0.001), less common diagnoses (7.4 to 15.8%; P < 0.001), and undefined/unknown diagnoses (1.3 to 8.6%; P < 0.001) were observed. Use of arginine, clonidine, and L-dopa tests declined, whereas use of the GHRH-arginine test increased. Median values for peak GH from all tests except GHRH-arginine and for IGF-I SD scores increased significantly (P < 0.001). Over the decade (1996--2005), idiopathic GHD was reported for 16.7% of patients, and more than half of these had adult onset GHD. In the idiopathic adult onset group, 40.2% had isolated GHD; 18.3 and 4.4% had a stimulation test GH peak of at least 3.0 and 5.0 microg/liter, respectively.</p><p>CONCLUSIONS: Significant shifts in diagnostic patterns have occurred since approval of the adult GHD indication, with a trend to less severe forms of GHD.</p>}},
author = {{Webb, Susan M and Strasburger, Christian J and Mo, Daojun and Hartman, Mark L and Melmed, Shlomo and Jung, Heike and Blum, Werner F and Attanasio, Andrea F}},
issn = {{0021-972X}},
keywords = {{Adult; Age of Onset; Arginine/analysis; Databases, Factual; Diagnostic Techniques, Endocrine/trends; Female; Growth Disorders/classification; Growth Hormone-Releasing Hormone/analysis; Human Growth Hormone/deficiency; Humans; Insulin Resistance/physiology; Male; Middle Aged; Pituitary Diseases/complications; Population Surveillance/methods; Professional Practice/trends}},
language = {{eng}},
number = {{2}},
pages = {{9--392}},
publisher = {{Oxford University Press}},
series = {{The Journal of clinical endocrinology and metabolism}},
title = {{Changing patterns of the adult growth hormone deficiency diagnosis documented in a decade-long global surveillance database}},
url = {{http://dx.doi.org/10.1210/jc.2008-0713}},
doi = {{10.1210/jc.2008-0713}},
volume = {{94}},
year = {{2009}},
}