Pituitary & hypothalamus

Cardiovascular risk and glucocorticoids: a Dutch National Registry of growth hormone treatment in adults with growth hormone deficiency analysis

PituitaryPublished Retrospective cohort study

Authors' conclusion

We found no clear evidence to support our hypothesis that patients with hypopituitarism and concomitant AI have worse cardiovascular outcomes than non-AI patients. This suggests that glucocorticoid replacement therapy in AI may be safer than previously thought. However, cardiovascular burden, events and medication use at baseline and during GHRT (in unadjusted models) were higher in AI; so the lack of power, the important role of (adjusting for) other risk factors, and the inability to distinguish between glucocorticoid treatment regimens may have influenced the outcomes.

Study context

Population
Adults with growth hormone deficiency (GHD) from the Dutch National Registry of Growth Hormone Treatment in adults
Participants
1,836 vs 750
Exposure
Concomitant adrenal insufficiency (AI) vs no AI in adults with GHD on GHRT
  • AIn = 1,836
  • non-AIn = 750reference
Outcome
Cardiovascular risk and outcomes, at baseline and during GHRT
Methodological detailsnationwide
  • Nationwide

Main finding

As reported in the abstract

Cardiovascular outcomes during GHRT
AI vs non-AIHazard ratio (CI)
Peripheral arterial disease; difference disappeared after adjustment for baseline differences
2.22(1.06–4.65)
Non-fatal cerebrovascular events; difference disappeared after adjustment for baseline differences
3.47(1.60–7.52)
AI more likely to use cardiovascular drugs
P ≤ 0.01

Observational data: associations, not effects.

Further findings

Baseline total and LDL cholesterol

Higher total and LDL cholesterol in AI
both p < 0.01

Original publication

Cardiovascular risk and glucocorticoids: a Dutch National Registry of growth hormone treatment in adults with growth hormone deficiency analysis. Pituitary. Published 31 August 2024. doi:10.1007/s11102-024-01448-2

Composed by AI from the published abstract and checked against it. How Briefs are made →

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