Growth Hormone Replacement Ups Diabetes Incidence

Higher plasma glucose, HbA1c in adult patients with growth hormone deficiency

FRIDAY, Nov. 18 (HealthDay News) -- Growth hormone (GH) replacement therapy (GHRT) in adult patients with GH deficiency increases the risk of developing diabetes, according to a study published online Nov. 10 in Diabetes Care.

Anton Luger, M.D., from the Medical University of Vienna in Austria, and colleagues determined the incidence of diabetes during GHRT, and examined the effect of GHRT on fasting plasma glucose concentrations and HbA1c in 5,143 adult patients with GH deficiency (mean observation period, 3.9 years; 20,106 patient years). Comparison was made between the observed number of cases (O) and expected number of cases (E), with reference rates from Sweden, three other European regions, and one U.S. region.

The investigators found that, compared to patients who did not develop diabetes, the 523 patients who developed diabetes were older, had higher blood pressure, waist circumference, body mass index (BMI), and triglyceride concentrations, as well as lower high-density lipoprotein-cholesterol concentrations. Both genders had a diabetes incidence of 2.6 per 100 patient-years, which was significantly higher than the Swedish and other reference rates (O/E =6.02 and 2.11 to 5.22, respectively). O/E increased and decreased significantly with BMI and duration of GHRT, respectively, but had no significant association with GH dose and insulin-like growth factor-1 standard deviation score. In patients who did not develop diabetes after six years of GHRT, the average plasma glucose concentration increased from 84.4 to 89.5 mg/dL, and HbA1c increased from 4.74 to 5.09 percent.

"Diabetes incidence appears to be increased in GH-deficient patients receiving GHRT," the authors write.

Two of the study authors disclosed financial ties to Pfizer Inc., which funded the KIMS database used in the study. Several of the study authors disclosed financial ties to KIMS.

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