Association between overweight and growth hormone secretion in patients with non-functioning pituitary tumors.
Seki. Yasufumi Y; Ichihara. Atsuhiro A
Key Findings
- 43% of the studied patients showed severe GH deficiency using GHRP‑2 testing.
- Higher body‑mass index was linked to a lower peak GH response to GHRP‑2.
- Overweight patients had an odds ratio of 3.86 for severe GH deficiency after adjusting for other factors.
- The negative impact of tumor size on GH response was stronger in overweight individuals.
- Post‑surgery, all overweight patients still had severe GH deficiency, compared to about half of non‑overweight patients.
Practical Outcomes
- If you’re overweight, GHRP‑2 may not boost your growth hormone as effectively, especially if you have any pituitary issues. Losing weight could improve the hormone‑releasing response. Use this info to set realistic expectations for GHRP‑2 supplementation and consider monitoring GH levels if you have a known pituitary tumor.
Summary
In people with non‑functioning pituitary tumors, being overweight makes it harder for the GH‑releasing peptide GHRP‑2 to trigger a strong growth‑hormone surge. Overweight patients were almost four times more likely to have severe GH deficiency, especially when the tumor was larger.
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.
Study Information
pubmed
2022
2022-04-22T00:00:00.000Z
10.1371/journal.pone.0267324
3
28