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Overall and cause-s...
Overall and cause-specific mortality in GH-deficient adults on GH replacement
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Gaillard, R. C. (author)
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Mattsson, A. F. (author)
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Akerblad, A. C. (author)
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- Bengtsson, Bengt-Åke, 1944 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition
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Cara, J. (author)
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Feldt-Rasmussen, U. (author)
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Koltowska-Haggstrom, M. (author)
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Monson, J. P. (author)
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Saller, B. (author)
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Wilton, P. (author)
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Abs, R. (author)
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(creator_code:org_t)
- Oxford University Press (OUP), 2012
- 2012
- English.
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In: European Journal of Endocrinology. - : Oxford University Press (OUP). - 0804-4643 .- 1479-683X. ; 166:6, s. 1069-1077
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https://eje.bioscien...
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Objective: Hypopituitarism is associated with an increased mortality rate but the reasons underlying this have not been fully elucidated. The purpose of this study was to evaluate mortality and associated factors within a large GH-replaced population of hypopituitary patients. Design: In KIMS (Pfizer International Metabolic Database) 13 983 GH-deficient patients with 69 056 patient-years of follow-up were available. Methods: This study analysed standardised mortality ratios (SMRs) by Poisson regression. IGF1 SDS was used as an indicator of adequacy of GH replacement. Statistical significance was set to P<0.05. Results: All-cause mortality was 13% higher compared with normal population rates (SMR, 1.13; 95% confidence interval, 1.04-1.24). Significant associations were female gender, younger age at follow-up, underlying diagnosis of Cushing's disease, craniopharyngioma and aggressive tumour and presence of diabetes insipidus. After controlling for confounding factors, there were statistically significant negative associations between IGF1 SDS after 1, 2 and 3 years of GH replacement and SMR. For cause-specific mortality there was a negative association between 1-year IGF1 SDS and SMR for deaths from cardiovascular diseases (P=0.017) and malignancies (P=0.044). Conclusions: GH-replaced patients with hypopituitarism demonstrated a modest increase in mortality rate; this appears lower than that previously published in GH-deficient patients. Factors associated with increased mortality included female gender, younger attained age, aetiology and lower IGF1 SDS during therapy. These data indicate that GH replacement in hypopituitary adults with GH deficiency may be considered a safe treatment.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- growth-hormone deficiency
- hypopituitary adults
- premature mortality
- cardiovascular risk
- pituitary-adenoma
- disease
- therapy
- association
- life
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Gaillard, R. C.
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Mattsson, A. F.
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Akerblad, A. C.
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Bengtsson, Bengt ...
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Cara, J.
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Feldt-Rasmussen, ...
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show more...
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Koltowska-Haggst ...
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Monson, J. P.
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Saller, B.
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Wilton, P.
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Abs, R.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
- Articles in the publication
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European Journal ...
- By the university
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University of Gothenburg