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Erschienen in: Endocrine 1/2017

05.11.2016 | Meta-Analysis

Mortality in adults with hypopituitarism: a systematic review and meta-analysis

verfasst von: Sina Jasim, Fares Alahdab, Ahmed T. Ahmed, Shrikant Tamhane, Larry J. Prokop, Todd B. Nippoldt, M. Hassan Murad

Erschienen in: Endocrine | Ausgabe 1/2017

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Abstract

Purpose

Hypopituitarism is a rare disorder with significant morbidity. To study the evidence on the association of premature mortality and hypopituitarism.

Methods

A comprehensive search of multiple databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus was conducted through August, 2015. Eligible studies that evaluated patients with hypopituitarism and reported mortality estimates were selected following a predefined protocol. Reviewers, independently and in duplicate, extracted data and assessed the risk of bias.

Results

We included 12 studies (published 1996–2015) that reported on 23,515 patients. Compared to the general population, hypopituitarism was associated with an overall excess mortality (weighted SMR of 1.55; 95 % CI 1.14−2.11), I 2  = 97.8 %, P = 0.000. Risk factors for increased mortality included younger age at diagnosis, female gender, diagnosis of craniopharyngioma, radiation therapy, transcranial surgery, diabetes insipidus and hypogonadism.

Conclusion

Hypopituitarism may be associated with premature mortality in adults. Risk is particularly higher in women and those diagnosed at a younger age.
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Literatur
2.
Zurück zum Zitat M. Regal, C. Paramo, S.M. Sierra, R.V. Garcia-Mayor, Prevalence and incidence of hypopituitarism in an adult caucasian population in northwestern Spain. Clin. Endocrinol. (Oxf). 55(6), 735–740 (2001). doi:1406 [pii]CrossRefPubMed M. Regal, C. Paramo, S.M. Sierra, R.V. Garcia-Mayor, Prevalence and incidence of hypopituitarism in an adult caucasian population in northwestern Spain. Clin. Endocrinol. (Oxf). 55(6), 735–740 (2001). doi:1406 [pii]CrossRefPubMed
3.
Zurück zum Zitat T. Rosen, B.A. Bengtsson, Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 336(8710), 285–288 (1990). doi:0140-6736(90)91812-O [pii]CrossRefPubMed T. Rosen, B.A. Bengtsson, Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 336(8710), 285–288 (1990). doi:0140-6736(90)91812-O [pii]CrossRefPubMed
4.
Zurück zum Zitat J.W. Tomlinson, N. Holden, R.K. Hills, K. Wheatley, R.N. Clayton, A.S. Bates, M.C. Sheppard, P.M. Stewart, Association between premature mortality and hypopituitarism. West midlands prospective hypopituitary study group. Lancet 357(9254), 425–431 (2001). doi:S014067360004006X [pii]CrossRefPubMed J.W. Tomlinson, N. Holden, R.K. Hills, K. Wheatley, R.N. Clayton, A.S. Bates, M.C. Sheppard, P.M. Stewart, Association between premature mortality and hypopituitarism. West midlands prospective hypopituitary study group. Lancet 357(9254), 425–431 (2001). doi:S014067360004006X [pii]CrossRefPubMed
5.
Zurück zum Zitat A.S. Bates, W. Van’t Hoff, J.M. Jones, R.N. Clayton, An audit of outcome of treatment in acromegaly. Q. J. Med. 86(5), 293–299 (1993)PubMed A.S. Bates, W. Van’t Hoff, J.M. Jones, R.N. Clayton, An audit of outcome of treatment in acromegaly. Q. J. Med. 86(5), 293–299 (1993)PubMed
6.
Zurück zum Zitat S.M. Orme, R.J. McNally, R.A. Cartwright, P.E. Belchetz, Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom acromegaly study group. J. Clin. Endocrinol. Metab. 83(8), 2730–2734 (1998). doi:10.1210/jcem.83.8.5007 PubMed S.M. Orme, R.J. McNally, R.A. Cartwright, P.E. Belchetz, Mortality and cancer incidence in acromegaly: a retrospective cohort study. United Kingdom acromegaly study group. J. Clin. Endocrinol. Metab. 83(8), 2730–2734 (1998). doi:10.​1210/​jcem.​83.​8.​5007 PubMed
7.
Zurück zum Zitat H.J. Schneider, I. Kreitschmann-Andermahr, E. Ghigo, G.K. Stalla, A. Agha, Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA 298(12), 1429–1438 (2007). doi:298/12/1429 [pii]10.1001/jama.298.12.1429CrossRefPubMed H.J. Schneider, I. Kreitschmann-Andermahr, E. Ghigo, G.K. Stalla, A. Agha, Hypothalamopituitary dysfunction following traumatic brain injury and aneurysmal subarachnoid hemorrhage: a systematic review. JAMA 298(12), 1429–1438 (2007). doi:298/12/1429 [pii]10.1001/jama.298.12.1429CrossRefPubMed
8.
Zurück zum Zitat A. Agha, M. Sherlock, S. Brennan, S.A. O’Connor, E. O’Sullivan, B. Rogers, C. Faul, D. Rawluk, W. Tormey, C.J. Thompson, Hypothalamic-pituitary dysfunction after irradiation of nonpituitary brain tumors in adults. J. Clin. Endocrinol. Metab. 90(12), 6355–6360 (2005). doi:jc.2005-1525 [pii]10.1210/jc.2005-1525CrossRefPubMed A. Agha, M. Sherlock, S. Brennan, S.A. O’Connor, E. O’Sullivan, B. Rogers, C. Faul, D. Rawluk, W. Tormey, C.J. Thompson, Hypothalamic-pituitary dysfunction after irradiation of nonpituitary brain tumors in adults. J. Clin. Endocrinol. Metab. 90(12), 6355–6360 (2005). doi:jc.2005-1525 [pii]10.1210/jc.2005-1525CrossRefPubMed
10.
Zurück zum Zitat B. Bulow, L. Hagmar, Z. Mikoczy, C.H. Nordstrom, E.M. Erfurth, Increased cerebrovascular mortality in patients with hypopituitarism. Clin. Endocrinol. (Oxf). 46(1), 75–81 (1997)CrossRefPubMed B. Bulow, L. Hagmar, Z. Mikoczy, C.H. Nordstrom, E.M. Erfurth, Increased cerebrovascular mortality in patients with hypopituitarism. Clin. Endocrinol. (Oxf). 46(1), 75–81 (1997)CrossRefPubMed
11.
Zurück zum Zitat B. Nilsson, E. Gustavasson-Kadaka, B.A. Bengtsson, B. Jonsson, Pituitary adenomas in Sweden between 1958 and 1991: incidence, survival, and mortality. J. Clin. Endocrinol. Metab. 85(4), 1420–1425 (2000). doi:10.1210/jcem.85.4.6498 PubMed B. Nilsson, E. Gustavasson-Kadaka, B.A. Bengtsson, B. Jonsson, Pituitary adenomas in Sweden between 1958 and 1991: incidence, survival, and mortality. J. Clin. Endocrinol. Metab. 85(4), 1420–1425 (2000). doi:10.​1210/​jcem.​85.​4.​6498 PubMed
12.
13.
Zurück zum Zitat D.S. Olsson, A.G. Nilsson, I.L. Bryngelsson, P. Trimpou, G. Johannsson, E. Andersson, Excess mortality in women and young adults with nonfunctioning pituitary adenoma: a swedish nationwide study. J. Clin. Endocrinol. Metab. 100(7), 2651–2658 (2015). doi:10.1210/jc.2015-1475 CrossRefPubMed D.S. Olsson, A.G. Nilsson, I.L. Bryngelsson, P. Trimpou, G. Johannsson, E. Andersson, Excess mortality in women and young adults with nonfunctioning pituitary adenoma: a swedish nationwide study. J. Clin. Endocrinol. Metab. 100(7), 2651–2658 (2015). doi:10.​1210/​jc.​2015-1475 CrossRefPubMed
14.
Zurück zum Zitat J.M. Pappachan, D. Raskauskiene, V.R. Kutty, R.N. Clayton, Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies. J. Clin. Endocrinol. Metab. 100(4), 1405–1411 (2015). doi:10.1210/jc.2014-3787 CrossRefPubMed J.M. Pappachan, D. Raskauskiene, V.R. Kutty, R.N. Clayton, Excess mortality associated with hypopituitarism in adults: a meta-analysis of observational studies. J. Clin. Endocrinol. Metab. 100(4), 1405–1411 (2015). doi:10.​1210/​jc.​2014-3787 CrossRefPubMed
15.
Zurück zum Zitat D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys. Ther. 89(9), 873–880 (2009)PubMed D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Reprint--preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Phys. Ther. 89(9), 873–880 (2009)PubMed
16.
Zurück zum Zitat R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Control. Clin. Trials 7(3), 177–188 (1986). doi:0197-2456(86)90046-2 [pii]CrossRefPubMed R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Control. Clin. Trials 7(3), 177–188 (1986). doi:0197-2456(86)90046-2 [pii]CrossRefPubMed
18.
Zurück zum Zitat C.C. van Bunderen, I.C. van Nieuwpoort, L.I. Arwert, M.W. Heymans, A.A. Franken, H.P. Koppeschaar, A.J. van der Lely, M.L. Drent, 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. 96(10), 3151–3159 (2011). doi:10.1210/jc.2011-1215jc.2011-1215 CrossRefPubMed C.C. van Bunderen, I.C. van Nieuwpoort, L.I. Arwert, M.W. Heymans, A.A. Franken, H.P. Koppeschaar, A.J. van der Lely, M.L. Drent, 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. 96(10), 3151–3159 (2011). doi:10.​1210/​jc.​2011-1215jc.​2011-1215 CrossRefPubMed
19.
Zurück zum Zitat R.C. Gaillard, A.F. Mattsson, A.C. Akerblad, B.A. Bengtsson, J. Cara, U. Feldt-Rasmussen, M. Koltowska-Haggstrom, J.P. Monson, B. Saller, P. Wilton, R. Abs, Overall and cause-specific mortality in GH-deficient adults on GH replacement. Eur. J. Endocrinol. 166(6), 1069–1077 (2012). doi:10.1530/EJE-11-1028EJE-11-1028 CrossRefPubMed R.C. Gaillard, A.F. Mattsson, A.C. Akerblad, B.A. Bengtsson, J. Cara, U. Feldt-Rasmussen, M. Koltowska-Haggstrom, J.P. Monson, B. Saller, P. Wilton, R. Abs, Overall and cause-specific mortality in GH-deficient adults on GH replacement. Eur. J. Endocrinol. 166(6), 1069–1077 (2012). doi:10.​1530/​EJE-11-1028EJE-11-1028 CrossRefPubMed
20.
Zurück zum Zitat J. Lindholm, E.H. Nielsen, P. Bjerre, J.S. Christiansen, C. Hagen, S. Juul, J. Jorgensen, A. Kruse, P. Laurberg, K. Stochholm, Hypopituitarism and mortality in pituitary adenoma. Clin. Endocrinol. (Oxf). 65(1), 51–58 (2006). doi:CEN2545 [pii]10.1111/j.1365-2265.2006.02545.xCrossRefPubMed J. Lindholm, E.H. Nielsen, P. Bjerre, J.S. Christiansen, C. Hagen, S. Juul, J. Jorgensen, A. Kruse, P. Laurberg, K. Stochholm, Hypopituitarism and mortality in pituitary adenoma. Clin. Endocrinol. (Oxf). 65(1), 51–58 (2006). doi:CEN2545 [pii]10.1111/j.1365-2265.2006.02545.xCrossRefPubMed
21.
Zurück zum Zitat P. Burman, A.F. Mattsson, G. Johannsson, C. Hoybye, H. Holmer, P. Dahlqvist, K. Berinder, B.E. Engstrom, B. Ekman, E.M. Erfurth, J. Svensson, J. Wahlberg, F.A. Karlsson, Deaths among adult patients with hypopituitarism: hypocortisolism during acute stress, and de novo malignant brain tumors contribute to an increased mortality. J. Clin. Endocrinol. Metab. 98(4), 1466–1475 (2013). doi:10.1210/jc.2012-4059jc.2012-4059 CrossRefPubMed P. Burman, A.F. Mattsson, G. Johannsson, C. Hoybye, H. Holmer, P. Dahlqvist, K. Berinder, B.E. Engstrom, B. Ekman, E.M. Erfurth, J. Svensson, J. Wahlberg, F.A. Karlsson, Deaths among adult patients with hypopituitarism: hypocortisolism during acute stress, and de novo malignant brain tumors contribute to an increased mortality. J. Clin. Endocrinol. Metab. 98(4), 1466–1475 (2013). doi:10.​1210/​jc.​2012-4059jc.​2012-4059 CrossRefPubMed
22.
Zurück zum Zitat E.H. Nielsen, J. Lindholm, P. Laurberg, P. Bjerre, J.S. Christiansen, C. Hagen, S. Juul, J. Jorgensen, A. Kruse, K. Stochholm, Nonfunctioning pituitary adenoma: incidence, causes of death and quality of life in relation to pituitary function. Pituitary 10(1), 67–73 (2007). doi:10.1007/s11102-007-0018-x CrossRefPubMed E.H. Nielsen, J. Lindholm, P. Laurberg, P. Bjerre, J.S. Christiansen, C. Hagen, S. Juul, J. Jorgensen, A. Kruse, K. Stochholm, Nonfunctioning pituitary adenoma: incidence, causes of death and quality of life in relation to pituitary function. Pituitary 10(1), 67–73 (2007). doi:10.​1007/​s11102-007-0018-x CrossRefPubMed
23.
Zurück zum Zitat E.H. Nielsen, J. Lindholm, P. Laurberg, Excess mortality in women with pituitary disease: a meta-analysis. Clin. Endocrinol. (Oxf). 67(5), 693–697 (2007). doi:CEN2947 [pii]10.1111/j.1365-2265.2007.02947.xCrossRefPubMed E.H. Nielsen, J. Lindholm, P. Laurberg, Excess mortality in women with pituitary disease: a meta-analysis. Clin. Endocrinol. (Oxf). 67(5), 693–697 (2007). doi:CEN2947 [pii]10.1111/j.1365-2265.2007.02947.xCrossRefPubMed
24.
Zurück zum Zitat M.H. Murad, V.M. Montori, J.P. Ioannidis, R. Jaeschke, P.J. Devereaux, K. Prasad, I. Neumann, A. Carrasco-Labra, T. Agoritsas, R. Hatala, M.O. Meade, P. Wyer, D.J. Cook, G. Guyatt, How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA 312(2), 171–179 (2014). doi:10.1001/jama.2014.5559 CrossRefPubMed M.H. Murad, V.M. Montori, J.P. Ioannidis, R. Jaeschke, P.J. Devereaux, K. Prasad, I. Neumann, A. Carrasco-Labra, T. Agoritsas, R. Hatala, M.O. Meade, P. Wyer, D.J. Cook, G. Guyatt, How to read a systematic review and meta-analysis and apply the results to patient care: users’ guides to the medical literature. JAMA 312(2), 171–179 (2014). doi:10.​1001/​jama.​2014.​5559 CrossRefPubMed
25.
Zurück zum Zitat B.A. Swiglo, M.H. Murad, H.J. Schunemann, R. Kunz, R.A. Vigersky, G.H. Guyatt, V.M. Montori, A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J. Clin. Endocrinol. Metab. 93(3), 666–673 (2008). doi:10.1210/jc.2007-1907 CrossRefPubMed B.A. Swiglo, M.H. Murad, H.J. Schunemann, R. Kunz, R.A. Vigersky, G.H. Guyatt, V.M. Montori, A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J. Clin. Endocrinol. Metab. 93(3), 666–673 (2008). doi:10.​1210/​jc.​2007-1907 CrossRefPubMed
26.
Zurück zum Zitat H. Kaji, K. Chihara, Direct causes of death in Japanese patients with hypopituitarism as analyzed from a nation-wide autopsy database. Eur. J. Endocrinol. 150(2), 149–152 (2004). doi:1500149 [pii]CrossRefPubMed H. Kaji, K. Chihara, Direct causes of death in Japanese patients with hypopituitarism as analyzed from a nation-wide autopsy database. Eur. J. Endocrinol. 150(2), 149–152 (2004). doi:1500149 [pii]CrossRefPubMed
27.
Zurück zum Zitat S.M. Haffner, M.P. Stern, H.P. Hazuda, M. Rosenthal, J.A. Knapp, R.M. Malina, Role of obesity and fat distribution in non-insulin-dependent diabetes mellitus in Mexican Americans and non-hispanic whites. Diabetes Care 9(2), 153–161 (1986)CrossRefPubMed S.M. Haffner, M.P. Stern, H.P. Hazuda, M. Rosenthal, J.A. Knapp, R.M. Malina, Role of obesity and fat distribution in non-insulin-dependent diabetes mellitus in Mexican Americans and non-hispanic whites. Diabetes Care 9(2), 153–161 (1986)CrossRefPubMed
28.
Zurück zum Zitat A.H. Kissebah, N. Vydelingum, R. Murray, D.J. Evans, A.J. Hartz, R.K. Kalkhoff, P.W. Adams, Relation of body fat distribution to metabolic complications of obesity. J. Clin. Endocrinol. Metab. 54(2), 254–260 (1982). doi:10.1210/jcem-54-2-254 CrossRefPubMed A.H. Kissebah, N. Vydelingum, R. Murray, D.J. Evans, A.J. Hartz, R.K. Kalkhoff, P.W. Adams, Relation of body fat distribution to metabolic complications of obesity. J. Clin. Endocrinol. Metab. 54(2), 254–260 (1982). doi:10.​1210/​jcem-54-2-254 CrossRefPubMed
29.
Zurück zum Zitat M. Leonsson, J. Hulthe, J. Oscarsson, G. Johannsson, I. Wendelhag, J. Wikstrand, B.A. Bengtsson, Intima-media thickness in cardiovascularly asymptomatic hypopituitary adults with growth hormone deficiency: relation to body mass index, gender, and other cardiovascular risk factors. Clin. Endocrinol. (Oxf). 57(6), 751–759 (2002). doi:1663 [pii]CrossRefPubMed M. Leonsson, J. Hulthe, J. Oscarsson, G. Johannsson, I. Wendelhag, J. Wikstrand, B.A. Bengtsson, Intima-media thickness in cardiovascularly asymptomatic hypopituitary adults with growth hormone deficiency: relation to body mass index, gender, and other cardiovascular risk factors. Clin. Endocrinol. (Oxf). 57(6), 751–759 (2002). doi:1663 [pii]CrossRefPubMed
31.
Zurück zum Zitat M. Pfeifer, R. Verhovec, B. Zizek, J. Prezelj, P. Poredos, R.N. Clayton, Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. J. Clin. Endocrinol. Metab. 84(2), 453–457 (1999). doi:10.1210/jcem.84.2.5456 PubMed M. Pfeifer, R. Verhovec, B. Zizek, J. Prezelj, P. Poredos, R.N. Clayton, Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. J. Clin. Endocrinol. Metab. 84(2), 453–457 (1999). doi:10.​1210/​jcem.​84.​2.​5456 PubMed
32.
Zurück zum Zitat R.W. McCallum, J.R. Petrie, A.F. Dominiczak, J.M. Connell, Growth hormone deficiency and vascular risk. Clin. Endocrinol. (Oxf). 57(1), 11–24 (2002). doi:1559 [pii]CrossRefPubMed R.W. McCallum, J.R. Petrie, A.F. Dominiczak, J.M. Connell, Growth hormone deficiency and vascular risk. Clin. Endocrinol. (Oxf). 57(1), 11–24 (2002). doi:1559 [pii]CrossRefPubMed
33.
Zurück zum Zitat J.K. Devin, L.S. Blevins Jr., D.K. Verity, Q. Chen, J.R. Bloodworth Jr., J. Covington, D.E. Vaughan, Markedly impaired fibrinolytic balance contributes to cardiovascular risk in adults with growth hormone deficiency. J. Clin. Endocrinol. Metab. 92(9), 3633–3639 (2007). doi:jc.2007-0609 [pii]10.1210/jc.2007-0609CrossRefPubMed J.K. Devin, L.S. Blevins Jr., D.K. Verity, Q. Chen, J.R. Bloodworth Jr., J. Covington, D.E. Vaughan, Markedly impaired fibrinolytic balance contributes to cardiovascular risk in adults with growth hormone deficiency. J. Clin. Endocrinol. Metab. 92(9), 3633–3639 (2007). doi:jc.2007-0609 [pii]10.1210/jc.2007-0609CrossRefPubMed
34.
Zurück zum Zitat J.O. Johansson, K. Landin, L. Tengborn, T. Rosen, B.A. Bengtsson, High fibrinogen and plasminogen activator inhibitor activity in growth hormone-deficient adults. Arterioscler. Thromb. 14(3), 434–437 (1994)CrossRefPubMed J.O. Johansson, K. Landin, L. Tengborn, T. Rosen, B.A. Bengtsson, High fibrinogen and plasminogen activator inhibitor activity in growth hormone-deficient adults. Arterioscler. Thromb. 14(3), 434–437 (1994)CrossRefPubMed
35.
Zurück zum Zitat J.O. Johansson, K. Landin, G. Johannsson, L. Tengborn, B.A. Bengtsson, Long-term treatment with growth hormone decreases plasminogen activator inhibitor-1 and tissue plasminogen activator in growth hormone-deficient adults. Thromb. Haemost. 76(3), 422–428 (1996)PubMed J.O. Johansson, K. Landin, G. Johannsson, L. Tengborn, B.A. Bengtsson, Long-term treatment with growth hormone decreases plasminogen activator inhibitor-1 and tissue plasminogen activator in growth hormone-deficient adults. Thromb. Haemost. 76(3), 422–428 (1996)PubMed
36.
Zurück zum Zitat J. Kvasnicka, J. Marek, T. Kvasnicka, V. Weiss, M. Markova, J. Stepan, A. Umlaufova, Increase of adhesion molecules, fibrinogen, type-1 plasminogen activator inhibitor and orosomucoid in growth hormone (GH) deficient adults and their modulation by recombinant human GH replacement. Clin. Endocrinol. (Oxf). 52(5), 543–548 (2000). doi:cen1002 [pii]CrossRefPubMed J. Kvasnicka, J. Marek, T. Kvasnicka, V. Weiss, M. Markova, J. Stepan, A. Umlaufova, Increase of adhesion molecules, fibrinogen, type-1 plasminogen activator inhibitor and orosomucoid in growth hormone (GH) deficient adults and their modulation by recombinant human GH replacement. Clin. Endocrinol. (Oxf). 52(5), 543–548 (2000). doi:cen1002 [pii]CrossRefPubMed
37.
Zurück zum Zitat S. Eden, O. Wiklund, J. Oscarsson, T. Rosen, B.A. Bengtsson, Growth hormone treatment of growth hormone-deficient adults results in a marked increase in Lp(a) and HDL cholesterol concentrations. Arterioscler. Thromb. 13(2), 296–301 (1993)CrossRefPubMed S. Eden, O. Wiklund, J. Oscarsson, T. Rosen, B.A. Bengtsson, Growth hormone treatment of growth hormone-deficient adults results in a marked increase in Lp(a) and HDL cholesterol concentrations. Arterioscler. Thromb. 13(2), 296–301 (1993)CrossRefPubMed
38.
Zurück zum Zitat D.J. O’Halloran, G. Wieringa, A. Tsatsoulis, S.M. Shalet, Increased serum lipoprotein(a) concentrations after growth hormone (GH) treatment in patients with isolated GH deficiency. Ann. Clin. Biochem. 33(Pt 4), 330–334 (1996)CrossRefPubMed D.J. O’Halloran, G. Wieringa, A. Tsatsoulis, S.M. Shalet, Increased serum lipoprotein(a) concentrations after growth hormone (GH) treatment in patients with isolated GH deficiency. Ann. Clin. Biochem. 33(Pt 4), 330–334 (1996)CrossRefPubMed
40.
Zurück zum Zitat K. Stochholm, C.H. Gravholt, T. Laursen, P. Laurberg, M. Andersen, L.O. Kristensen, U. Feldt-Rasmussen, J.S. Christiansen, M. Frydenberg, A. Green, Mortality and GH deficiency: a nationwide study. Eur. J. Endocrinol. 157(1), 9–18 (2007). doi:157/1/9 [pii]10.1530/EJE-07-0013CrossRefPubMed K. Stochholm, C.H. Gravholt, T. Laursen, P. Laurberg, M. Andersen, L.O. Kristensen, U. Feldt-Rasmussen, J.S. Christiansen, M. Frydenberg, A. Green, Mortality and GH deficiency: a nationwide study. Eur. J. Endocrinol. 157(1), 9–18 (2007). doi:157/1/9 [pii]10.1530/EJE-07-0013CrossRefPubMed
41.
Zurück zum Zitat K.T. Khaw, M. Dowsett, E. Folkerd, S. Bingham, N. Wareham, R. Luben, A. Welch, N. Day, Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116(23), 2694–2701 (2007). doi:CIRCULATIONAHA.107.719005 [pii]10.1161/CIRCULATIONAHA.107.719005CrossRefPubMed K.T. Khaw, M. Dowsett, E. Folkerd, S. Bingham, N. Wareham, R. Luben, A. Welch, N. Day, Endogenous testosterone and mortality due to all causes, cardiovascular disease, and cancer in men: European prospective investigation into cancer in Norfolk (EPIC-Norfolk) prospective population study. Circulation 116(23), 2694–2701 (2007). doi:CIRCULATIONAHA.107.719005 [pii]10.1161/CIRCULATIONAHA.107.719005CrossRefPubMed
42.
Zurück zum Zitat J.C. Flickinger, P.B. Nelson, F.H. Taylor, A. Robinson, Incidence of cerebral infarction after radiotherapy for pituitary adenoma. Cancer 63(12), 2404–2408 (1989)CrossRefPubMed J.C. Flickinger, P.B. Nelson, F.H. Taylor, A. Robinson, Incidence of cerebral infarction after radiotherapy for pituitary adenoma. Cancer 63(12), 2404–2408 (1989)CrossRefPubMed
Metadaten
Titel
Mortality in adults with hypopituitarism: a systematic review and meta-analysis
verfasst von
Sina Jasim
Fares Alahdab
Ahmed T. Ahmed
Shrikant Tamhane
Larry J. Prokop
Todd B. Nippoldt
M. Hassan Murad
Publikationsdatum
05.11.2016
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 1/2017
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-016-1159-3

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