PURPOSE Uncertainties exist about the predictors of the severity of the clinical picture of GH deficiency (GHD) syndrome. Aim of the study was to evaluate, in adult patients with GHD, the predictors of the development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis. METHODS We retrospectively studied 327 adult patients (age 47.1 ± 17.1 years) with untreated severe GHD (mean follow-up 110.9 ± 56.8 months). GHD was defined by GHRH + arginine test using BMI cut-offs. The possible development of hypercholesterolemia, hypertension, diabetes mellitus, and osteoporosis was investigated by Kaplan-Meier survival analysis. For each clinical outcome, either a univariate or multivariate analysis according to the Cox proportional-hazards model was performed to identify those factors that were associated with the development of the event. RESULTS GH secretion parameters were not associated with the outcomes. Hypercholesterolemia was positively and negatively predicted by a BMI ≥ 30 kg/m2 (HR 2.50, p 0.00) and the dose of l-thyroxine possibly in place (HR 0.98, p 0.02), respectively. Hypertension was positively predicted by a BMI ≥ 30 kg/m2 (HR 2.64, p 0.00) and IGF-I SDS values (HR 2.26, p 0.00). Diabetes mellitus was positively predicted by hypertension (HR 11.76, p 0.01). Osteoporosis was positively and negatively predicted by hypercholesterolemia (HR 3.25, p 0.01) and hypertension (HR 0.21, p 0.00), respectively. CONCLUSIONS The severity of the impairment of GH secretion does not predict the development of the clinical picture of GHD syndrome: untreated adult GHD does not increase the development of metabolic risk factors in hypopituitaric patients.

中文翻译：

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未经治疗的成人GH缺乏症与代谢危险因素的发展无关：一项长期的观察性研究。

目的GH缺乏症（GHD）综合征临床症状严重程度的预测因素存在不确定性。该研究的目的是评估GHD成年患者中高胆固醇血症，高血压，糖尿病和骨质疏松症发展的预测因素。方法我们回顾性研究了327例未经治疗的严重GHD（平均随访时间110.9±56.8个月）的成年患者（年龄47.1±17.1岁）。GHD通过GHRH +精氨酸试验使用BMI临界值定义。通过Kaplan-Meier生存分析研究了高胆固醇血症，高血压，糖尿病和骨质疏松症的可能发展。对于每种临床结果，根据Cox比例风险模型进行了单变量或多变量分析，以识别与事件发展相关的那些因素。结果GH分泌参数与结果无关。BMI≥30 kg / m2（HR 2.50，p 0.00）和左旋甲状腺素的剂量可能适当地预测了高胆固醇血症（HR 0.98，p 0.02）。BMI≥30 kg / m2（HR 2.64，p 0.00）和IGF-I SDS值（HR 2.26，p 0.00）可以肯定地预测高血压。高血压对糖尿病有积极的预测作用（HR 11.76，p 0.01）。高胆固醇血症（HR 3.25，p 0.01）和高血压（HR 0.21，p 0.00）分别对骨质疏松症有正面和负面的预测。