Prevalence of GH and other anterior pituitary hormone deficiencies in adults with nonsecreting pituitary microadenomas and normal serum IGF-1 levels

• Published in: Clinical endocrinology (Oxford) 2008-08, Vol.69 (2), p.292-298
• Main Authors: Yuen, Kevin C. J., Cook, David M., Sahasranam, Prem, Patel, Pragnesh, Ghods, David E., Shahinian, Hrayr K., Friedman, Theodore C.
• Format: Article
• Language: English
• Subjects: Adenoma - blood; Adenoma - complications; Adenoma - epidemiology; Adenoma - secretion; Adult; Aged; Case-Control Studies; Female; Human Growth Hormone - deficiency; Humans; Hypopituitarism - blood; Hypopituitarism - epidemiology; Hypopituitarism - etiology; Insulin-Like Growth Factor I - analysis; Insulin-Like Growth Factor I - metabolism; Male; Middle Aged; Pituitary Hormones, Anterior - deficiency; Pituitary Neoplasms - blood; Pituitary Neoplasms - complications; Pituitary Neoplasms - epidemiology; Pituitary Neoplasms - secretion; Prevalence; Retrospective Studies
• ISSN: 0300-0664; 1365-2265
• DOI: 10.1111/j.1365-2265.2008.03201.x

Summary Objective  GH is usually the first pituitary hormone to be affected following a pathological insult to the pituitary; however, data on the prevalence of GH deficiency in patients with nonsecreting pituitary microadenomas and normal serum IGF‐1 levels are scarce. This study aims to evaluate the prevalence of GH and other anterior pituitary hormone deficiencies, and to determine whether microadenomas per se could be associated with reduced GH response rates to GHRH–arginine stimulation. Design  Analytical, retrospective, two‐site case‐control study. Patients and methods  Thirty‐eight patients with nonsecreting pituitary microadenomas (mean size 4·2 mm) and normal serum IGF‐1 levels were studied. Anterior pituitary function testing, including the GHRH–arginine test to examine GH reserve, was performed in all patients. Serum IGF‐1 levels and peak GH levels in the patients that passed the GHRH–arginine test were compared with 22 age‐ and BMI‐matched healthy controls. Results  Nineteen patients (50%) failed the GHRH–arginine test and had higher body mass index (BMI) than those that passed the GHRH–arginine test and healthy controls. Peak GH levels in patients that passed the GHRH–arginine test were lower compared to healthy controls and 19 patients (50%) had at least one other pituitary hormone deficit. A negative correlation (r = –0·42, P