Department of Endocrinology, University Medical Center Groningen, University of Groningen, De Brug 4.069, AA 31, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
J Clin Endocrinol Metab. 2010 Aug;95(8):3664-74. doi: 10.1210/jc.2009-2506. Epub 2010 May 19.
The prevalence of obesity is increased in hypopituitarism. In the general population, body mass index (BMI) and waist circumference increase with advancing age. It remains uncertain whether age-related changes in pituitary function contribute to the changes in body composition associated with advancing years.
Our objective was to study the relationship between pituitary function, body composition, and age in a large cohort of patients with hypopituitarism and a matched reference population.
DESIGN, SETTING, AND PARTICIPANTS: A total of 3632 GH-deficient adults with hypopituitarism, adequately replaced with all pituitary hormones except for GH, from the prospective KIMS database (Pfizer International Metabolic Database) were included in present analysis. A random sample of the general population (3427 subjects) was used as reference. Patients and controls were grouped by gender in five age cohorts of 10 yr from 28 yr onward.
Differences in BMI and waist circumference were evaluated.
Patients had a significantly higher BMI and waist circumference than controls, with larger differences at younger age. With advancing age, an increase in BMI and waist circumference was seen in controls but was virtually absent in the patients with adult-onset GH deficiency and hypopituitarism.
Patients with hypopituitarism have more excess body fat than age-matched controls, especially in the youngest age groups. The normal increase in fat mass with advancing age is not seen in adult-onset GH-deficient hypopituitarism, suggesting a potential role for the normal pituitary gland as an age-dependent regulator of body composition in adult life.
垂体功能减退症患者中肥胖的患病率增加。在普通人群中，体重指数（BMI）和腰围随年龄增长而增加。目前尚不清楚与年龄相关的垂体功能变化是否会导致与年龄相关的身体成分变化。
我们的目的是在大量垂体功能减退症患者和匹配的参考人群中研究垂体功能、身体成分与年龄之间的关系。
设计、地点和参与者：本研究共纳入了来自前瞻性 KIMS 数据库（辉瑞国际代谢数据库）的 3632 名生长激素缺乏的成年垂体功能减退症患者，这些患者除生长激素外，所有垂体激素均得到充分替代。随机抽取普通人群（3427 名受试者）作为对照。根据性别，将患者和对照分为五个年龄组（28 岁以后每 10 岁一组）。
评估 BMI 和腰围的差异。
与对照组相比，患者的 BMI 和腰围明显更高，且在较年轻的年龄组中差异更大。随着年龄的增长，对照组的 BMI 和腰围增加，但在成年期发生 GH 缺乏和垂体功能减退症的患者中几乎没有增加。
与年龄匹配的对照组相比，垂体功能减退症患者的体脂过多，尤其是在年龄最小的年龄组。在成年期发生 GH 缺乏的垂体功能减退症中，随着年龄的增长，脂肪量正常增加的现象并不明显，这表明正常垂体可能作为成年期身体成分的年龄依赖性调节剂发挥作用。
