Is GH dosing optimal in female patients with adult‐onset GH deficiency? An analysis from the NordiNet® International Outcome Study. (19th April 2017)

• Record Type: Journal Article
• Authors: Höybye, Charlotte; Weber, Matthias M.; Pournara, Effie; Tønnes Pedersen, Birgitte; Biller, Beverly M. K.
• Is Part Of: Clinical endocrinology. Volume 86:Number 6(2017)
• Page Start: 798
• Page End: 805
• Publication Date: 2017-04-19
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.13330
• Languages: English
• ISSNs: 0300-0664

Abstract

Summary: Objective: To evaluate gender differences in GH dosing, IGF‐I and cardiovascular risk markers in adults with GH deficiency (GHD). Design: NordiNet ® International Outcome Study (NCT00960128), a noninterventional, multicentre study, evaluates the long‐term effectiveness and safety of Norditropin ® (Novo Nordisk A/S) in the real‐life clinical setting. Patients: Nondiabetic patients ( n = 252; 41·7% female) with adult‐onset GHD (age ≥20 years at GH start), ≥4 years' GH therapy and glycosylated haemoglobin (HbA1c ) data at baseline and 4 years. Measurements: Effects of gender (adjusted for baseline age and body mass index [BMI], average GH dose, treatment duration and concomitant medication) on change from baseline to 4 years (∆) in HbA1c, fasting plasma glucose (FPG), IGF‐I, lipids and waist circumference were evaluated. Results: GH dose (mean [SE]; mg/day) was similar between females (0·22 [0·02]) and males (0·21 [0·01]) at baseline, but higher in females from year 1 (year 4, females, 0·45 [0·03]; males, 0·32 [0·02]). Mean IGF‐I standard deviation score [SDS] was lower in females vs males at each treatment year; more than one‐third of females still had an IGF‐I SDS below 0 at year 4, compared with only 21·8% of men. An adverse lipid profile at baseline remained poor in more females than males at 4 years. Improvement in total cholesterol was significantly associated with gender ( P < 0·0001), improving less in females than in males. Conclusions: These data highlight that, even after 4 years, GH dose is suboptimal in many female patients, which may impact clinical outcomes; therefore, GH titration for women requires further improvement.