Antwerp Centre for Endocrinology, Grotesteenweg 556, B-2600 Berchem, Antwerp, Belgium.
Eur J Endocrinol. 2013 Feb 15;168(3):297-305. doi: 10.1530/EJE-12-0807. Print 2013 Mar.
GH deficiency (GHD) in adults is characterized by a tendency toward obesity and an adverse body composition with visceral fat deposit and may thus predispose to the development of type 2 diabetes mellitus. The aim of this study was to assess the observed prevalence proportion (PP) and observed PP over expected PP ratio (standardized prevalence proportion ratio, SPR) of diabetes according to International Diabetes Federation criteria in a large cohort of GH-untreated adult-onset GHD patients.
Associations between baseline variables and diabetes prevalence in 6050 GHD patients from KIMS (Pfizer International Metabolic Database) were studied and robust Poisson-regression analyses were performed. Comparisons between baseline status and HbA1c categories in the nondiabetic patients were done with covariance analysis. P values <0.05 were considered statistically significant.
PP was 9.3% compared with the expected 8.2%. SPR was 1.13 (95% confidence intervals (95% CIs), 1.04-1.23), which was significantly increased in females (1.23; 95% CI, 1.09-1.38%) but not in males (SPR 1.04; 95% CI, 0.92-1.17%). PP increased significantly by age, familial diabetes, country selection, BMI, waist circumference, number of pituitary deficiencies, and GHD etiology. SPR decreased significantly by age and increased significantly by BMI, waist circumference, and IGF1 SDS. Multiple regression model showed that the most important impact on SPR was from age and BMI. HbA1c values of 6.0-6.5% were found in 9.5% of nondiabetic patients and were associated with higher BMI and waist circumference.
GHD is associated with an increased prevalence of diabetes, largely to be explained by the adverse body composition. These data urge toward early initiation of lifestyle modification measures.
成人生长激素缺乏症（GHD）的特征是倾向于肥胖和不良的身体成分，内脏脂肪沉积，因此可能导致 2 型糖尿病的发生。本研究的目的是根据国际糖尿病联合会（IDF）的标准，评估大量未经 GH 治疗的成年起病 GHD 患者中糖尿病的观察到的现患率（PP）和观察到的现患率与预期现患率的比值（标准化现患率比，SPR）。
研究了 KIMS（辉瑞国际代谢数据库）中 6050 例 GHD 患者的基线变量与糖尿病患病率之间的关系，并进行了稳健泊松回归分析。对非糖尿病患者的基线状况和 HbA1c 分类进行了协方差分析。P 值<0.05 被认为具有统计学意义。
PP 为 9.3%，而预期值为 8.2%。SPR 为 1.13（95%置信区间[95%CI]，1.04-1.23），女性明显升高（1.23；95%CI，1.09-1.38%），而男性无明显升高（SPR 1.04；95%CI，0.92-1.17%）。PP 随年龄、家族性糖尿病、国家选择、BMI、腰围、垂体功能减退症数量和 GHD 病因显著增加。SPR 随年龄显著降低，随 BMI、腰围和 IGF1 SDS 显著增加。多元回归模型显示，对 SPR 最重要的影响因素是年龄和 BMI。非糖尿病患者中 6.0-6.5%的 HbA1c 值发现与较高的 BMI 和腰围有关。
GHD 与糖尿病的患病率增加有关，主要原因是不良的身体成分。这些数据敦促尽早开始生活方式改变措施。
