Lipid Profile and Response to Statin Therapy in Patients with Hypopituitarism

Overview

Journal Arch Endocrinol Metab

Specialty Endocrinology

Date 2020 Oct 13

PMID 33049128

Citations 3

Authors

Graziela Rissetti

Debora Zeni

Barbara Roberta Ongaratti

Julia Fernanda Semmelmann Pereira-Lima

Carolina Garcia Soares Leaes Rech

Miriam da Costa Oliveira

Affiliations

Soon will be listed here.

Abstract

Objective: Dyslipidemia is prevalent among patients with hypopituitarism, especially in those with growth hormone (GH) deficiency. This study aimed to evaluate the response to statin therapy among adult patients with dyslipidemia and hypopituitarism.

Methods: A total of 113 patients with hypopituitarism following up at a neuroendocrinology unit were evaluated for serum lipid levels. Dyslipidemia was diagnosed in 72 (63.7%) of these patients. A control group included 57 patients with dyslipidemia and normal pituitary function. The distribution of gender, age, weight, and dyslipidemia type was well balanced across both groups, and all participants were treated with simvastatin at doses adjusted to obtain normal lipid levels.

Results: Patients with hypopituitarism and dyslipidemia presented deficiency of TSH (69%), gonadotropins (69%), ACTH (64%), and GH (55%) and had a similar number of deficient pituitary axes compared with patients with hypopituitarism but without dyslipidemia. All patients with dyslipidemia (with and without hypopituitarism) had lipid levels well controlled with doses of simvastatin ranging from 20-40 mg/day. The mean daily dose of simvastatin was not significantly different between patients with and without hypopituitarism (26.7 versus 23.5 mg, p = 0.10). Similarly, no significant variation in simvastatin dose was observed between patients with different causes of hypopituitarism, presence or absence of GH deficiency, number of deficient pituitary axes, prior pituitary radiation therapy or not, and presence or absence of obesity.

Conclusion: Patients with GH deficiency without GH replacement showed good response to simvastatin at a mean dose equivalent to that used in individuals with dyslipidemia and normal pituitary function.

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References

Murakami Y, Kato Y . Hypercholesterolemia and obesity in adult patients with hypopituitarism: a report of a nation-wide survey in Japan. Endocr J. 2004; 50(6):759-65. DOI: 10.1507/endocrj.50.759. View

Regal M, Paramo C, Sierra S, Garcia-Mayor R . Prevalence and incidence of hypopituitarism in an adult Caucasian population in northwestern Spain. Clin Endocrinol (Oxf). 2002; 55(6):735-40. DOI: 10.1046/j.1365-2265.2001.01406.x. View

Joustra S, Claessen K, Dekkers O, van Beek A, Wolffenbuttel B, Pereira A . High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma. PLoS One. 2014; 9(3):e90602. PMC: 3946551. DOI: 10.1371/journal.pone.0090602. View

Attanasio A, Mo D, Erfurth E, Tan M, Ho K, Kleinberg D . Prevalence of metabolic syndrome in adult hypopituitary growth hormone (GH)-deficient patients before and after GH replacement. J Clin Endocrinol Metab. 2009; 95(1):74-81. DOI: 10.1210/jc.2009-1326. View

Fernandes R, Christofaro D, Casonatto J, Codogno J, Rodrigues E, Cardoso M . Prevalence of dyslipidemia in individuals physically active during childhood, adolescence and adult age. Arq Bras Cardiol. 2011; 97(4):317-23. DOI: 10.1590/s0066-782x2011005000083. View

Monson J, Jonsson P, Koltowska-Haggstrom M, Kourides I . Growth hormone (GH) replacement decreases serum total and LDL-cholesterol in hypopituitary patients on maintenance HMG CoA reductase inhibitor (statin) therapy. Clin Endocrinol (Oxf). 2007; 67(4):623-8. PMC: 2040243. DOI: 10.1111/j.1365-2265.2007.02935.x. View

Mueller S, Fullerton H, Stratton K, Leisenring W, Weathers R, Stovall M . Radiation, atherosclerotic risk factors, and stroke risk in survivors of pediatric cancer: a report from the Childhood Cancer Survivor Study. Int J Radiat Oncol Biol Phys. 2013; 86(4):649-55. PMC: 3696633. DOI: 10.1016/j.ijrobp.2013.03.034. View

Xavier H, Izar M, Faria Neto J, Assad M, Rocha V, Sposito A . [V Brazilian Guidelines on Dyslipidemias and Prevention of Atherosclerosis]. Arq Bras Cardiol. 2013; 101(4 Suppl 1):1-20. DOI: 10.5935/abc.2013S010. View

Khang A, Ku E, Kim Y, Roh E, Bae J, Oh T . Sex differences in the prevalence of metabolic syndrome and its components in hypopituitary patients: comparison with an age- and sex-matched nationwide control group. Pituitary. 2016; 19(6):573-581. DOI: 10.1007/s11102-016-0747-9. View

10.

Bates A, Vant Hoff W, Jones P, Clayton R . The effect of hypopituitarism on life expectancy. J Clin Endocrinol Metab. 1996; 81(3):1169-72. DOI: 10.1210/jcem.81.3.8772595. View

11.

Gaillard R, Mattsson A, Akerblad A, Bengtsson B, Cara J, Feldt-Rasmussen U . Overall and cause-specific mortality in GH-deficient adults on GH replacement. Eur J Endocrinol. 2012; 166(6):1069-77. DOI: 10.1530/EJE-11-1028. View

12.

Gigante D, Moura E, Sardinha L . Prevalence of overweight and obesity and associated factors, Brazil, 2006. Rev Saude Publica. 2009; 43 Suppl 2:83-9. DOI: 10.1590/s0034-89102009000900011. View

13.

Verhelst J, Mattsson A, Luger A, Thunander M, Goth M, Koltowska-Haggstrom M . Prevalence and characteristics of the metabolic syndrome in 2479 hypopituitary patients with adult-onset GH deficiency before GH replacement: a KIMS analysis. Eur J Endocrinol. 2011; 165(6):881-9. DOI: 10.1530/EJE-11-0599. View

14.

Verhelst J, Abs R . Cardiovascular risk factors in hypopituitary GH-deficient adults. Eur J Endocrinol. 2009; 161 Suppl 1:S41-9. DOI: 10.1530/EJE-09-0291. View

15.

van Bunderen C, van Nieuwpoort I, Arwert L, Heymans M, Franken A, Koppeschaar H . Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency? Data from the Dutch National Registry of Growth Hormone Treatment in adults. J Clin Endocrinol Metab. 2011; 96(10):3151-9. DOI: 10.1210/jc.2011-1215. View

16.

Fernandez-Rodriguez E, Lopez-Raton M, Andujar P, Martinez-Silva I, Cadarso-Suarez C, Casanueva F . Epidemiology, mortality rate and survival in a homogeneous population of hypopituitary patients. Clin Endocrinol (Oxf). 2012; 78(2):278-84. DOI: 10.1111/j.1365-2265.2012.04516.x. View

17.

Bulow B, Hagmar L, Mikoczy Z, Nordstrom C, Erfurth E . Increased cerebrovascular mortality in patients with hypopituitarism. Clin Endocrinol (Oxf). 1997; 46(1):75-81. DOI: 10.1046/j.1365-2265.1997.d01-1749.x. View

18.

Tomlinson J, Holden N, Hills R, Wheatley K, Clayton R, Bates A . Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group. Lancet. 2001; 357(9254):425-31. DOI: 10.1016/s0140-6736(00)04006-x. View

19.

Prodam F, Gasco V, Caputo M, Zavattaro M, Pagano L, Marzullo P . Metabolic alterations in patients who develop traumatic brain injury (TBI)-induced hypopituitarism. Growth Horm IGF Res. 2013; 23(4):109-13. DOI: 10.1016/j.ghir.2013.04.001. View

20.

Claessen K, Appelman-Dijkstra N, Adoptie D, Roelfsema F, Smit J, Biermasz N . Metabolic profile in growth hormone-deficient (GHD) adults after long-term recombinant human growth hormone (rhGH) therapy. J Clin Endocrinol Metab. 2012; 98(1):352-61. DOI: 10.1210/jc.2012-2940. View