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. 2025 Feb 18;28(2):32.
doi: 10.1007/s11102-025-01500-9.

Prevalence and risk of complications in untreated patients with adult growth hormone deficiency

Hidenori Fukuoka  1 , Takaaki Endo  2 , Satoshi Tsuboi  3 , Shingo Fujio  4
Affiliations

Prevalence and risk of complications in untreated patients with adult growth hormone deficiency

Hidenori Fukuoka et al. Pituitary. .

Abstract

Purpose: Adult growth hormone deficiency (AGHD) increases the prevalence of complications, including metabolic disorder, leading to increased cardiovascular mortality from cardiovascular diseases. However, no large database studies have evaluated AGHD patients without GH replacement therapy (GHRT). We investigated the prevalence of AGHD-related complications in patients without GHRT.

Methods: Patients with AGHD and associated complications were identified from the Medical Data Vision claims database using Japanese local disease codes mapped to ICD-10 codes. The prevalence of AGHD-related complications in 2020 was estimated to compare with the prevalence in the Japanese general population in the latest available year 2020. Risk factors for complications were evaluated by Kaplan-Meier curves and a Cox proportional hazard model.

Results: We identified 8,809 untreated patients with AGHD from April 2008 to September 2022, including 3,430 in 2020. In 2020, the prevalence of complications was higher in the AGHD population adjusted for sex and age than in the Japanese general population, e.g., diabetes mellitus, 9.3% vs. 3.6%; osteoporosis, 4.8% vs. 1.3%; and dyslipidemia, 22.0% vs. 3.9%. Age was a significant risk factor for most complications, and female sex for osteoporosis. Diabetes mellitus was a significant risk factor for dyslipidemia, ischemic heart disease, cerebrovascular disease, and all-cause death.

Conclusion: Untreated patients with AGHD have a higher prevalence of metabolic complications than the general population despite no difference in their related risk factors. Given the low use of GHRT in this study, comprehensive treatment approaches that include GHRT need to be considered to alleviate the risk of complications.

Keywords: Adult growth hormone deficiency; Complications; Database study; Growth hormones; Prevalence; Real-world data.

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Conflict of interest statement

Declarations. Ethical approval: The study was approved by the MINS Research Ethics Committee (MINS-REC-230201; approved on January 19, 2023). Consent to participate: Not applicable. Consent to publish: Not applicable. Competing interests: HF received lecture fees from Novo Nordisk Pharma Ltd. TE and ST are employees of Novo Nordisk Pharma Ltd., and report stock ownership. SF received lecture fees from Novo Nordisk Pharma Ltd.

Figures

Fig. 1
Fig. 1
Study design aClaims are collected from hospitals on a monthly basis. bEarliest onset of AGHD-related complications or the last claim of the patient. ACTH, adrenocorticotropic hormone; AGHD, adult growth hormone deficiency; CCI, Charlson comorbidity index; DM, diabetes mellitus; GHD, growth hormone deficiency; Gn, gonadotropin; GHRT, growth hormone replacement therapy; TSH, thyroid stimulating hormone
Fig. 2
Fig. 2
Histogram of age at diagnosis of adult growth hormone deficiency by sex and history of pituitary tumor. (a) females without tumor (b) females with tumor (c) males without tumor (d) males with tumor. AGHD, adult growth hormone deficiency
Fig. 3
Fig. 3
Kaplan-Meier curve for onset of adult growth hormone deficiency-related complications by history of diabetes mellitus (DM; left) and malignant neoplasm (MN; right) (a) DM (b) dyslipidemia (c) osteoporosis (d) ischemic heart disease (e) cerebrovascular disease (f) all-cause death
See this image and copyright information in PMC

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