Study summary · research use only
Association between overweight and growth hormone secretion in patients with non-functioning pituitary tumors
Plain-language summary
Paraphrased from the published abstract below — not a verdict on whether anything works.
In this retrospective human study of adult patients with non-functioning pituitary adenoma (NFPA) or Rathke's cyst who underwent preoperative GH-releasing peptide-2 (GHRP-2) testing, researchers examined the relationship between growth hormone (GH) response and patient characteristics. Among 104 patients (85 NFPA and 19 Rathke's cysts), 45 (43%) had severe growth hormone deficiency (GHD) by GHRP-2 testing. Body mass index, free thyroxine, and tumor height were reported as significant variables associated with peak GH response, and overweight was significantly associated with severe GHD (odds ratio 3.86). Among 48 patients who underwent postoperative GHRP-2 testing, severe postoperative GHD was more common in overweight than non-overweight patients (100% vs. 48%). The authors suggest GH provocation testing be considered in overweight unoperated patients with large tumors.
Abstract
Growth hormone (GH) deficiency (GHD) is often complicated by non-functioning pituitary tumors (NFPTs); however, its prevalence remains unclear because preoperative screening for GHD with provocative tests is not recommended. Accordingly, we attempted to clarify the characteristics of GHD in unoperated patients with NFPT. We retrospectively reviewed adult patients with non-functioning pituitary adenoma (NFPA) and Rathke's cyst who underwent preoperative GH-releasing peptide-2 (GHRP-2) tests from January 2013 to December 2016. We investigated the association between peak GH response to GHRP-2 and background characteristics. Among 104 patients (85 NFPA and 19 Rathke's cysts), 45 (43%) presented severe GHD, as diagnosed using GHRP-2 tests. Body mass index (β = -0.210, P = 0.007), free thyroxine (β = 0.440, P < 0.001), and tumor height (β = -0.254, P < 0.001) were significant variables for determining the peak GH response to GHRP-2 in multiple regression analyses. Overweight (odds ratio, 3.86; 95% confidence interval, 1.02-14.66) was significantly associated with severe GHD after adjustment for age, sex, creatinine, free thyroxine, tumor height and clinical diagnosis. The regression slopes between tumor height and peak GH response to GHRP-2 significantly differed between overweight patients and non-overweight individuals, as determined by analysis of covariance (P = 0.040). In the 48 patients who underwent postoperative GHRP-2 tests, severe postoperative GHD was significantly more common in overweight patients than non-overweight individuals (100% vs. 48%, P < 0.001). We observed a negative synergistic effect between overweight and tumor size on GH secretion in patients with NFPTs, indicating that GH provocation tests for diagnosing underestimated GHD could be considered in overweight unoperated patients with large NFPTs.
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