Yuen Kevin C J, Birkegard Anna Camilla, Blevins Lewis S, Clemmons David R, Hoffman Andrew R, Kelepouris Nicky, Kerr Janice M, Tarp Jens M, Fleseriu Maria
Barrow Pituitary Center, Barrow Neurological Institute and St. Joseph's Hospital and Medical Center, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA.
Novo Nordisk A/S, Søborg, Denmark.
Int J Endocrinol. 2022 Jun 18;2022:7853786. doi: 10.1155/2022/7853786. eCollection 2022.
Adult growth hormone deficiency (AGHD) is an underdiagnosed disease associated with increased morbidity and mortality. Identifying people who may benefit from growth hormone (GH) therapy can be challenging, as many AGHD symptoms resemble those of aging. We developed an algorithm to potentially help providers stratify people by their likelihood of having AGHD.
The algorithm was developed with, and applied to, data in the anonymized Truven Health MarketScan® claims database. . A total of 135 million adults in the US aged ≥18 years with ≥6 months of data in the Truven database. . Proportion of people with high, moderate, or low likelihood of having AGHD, and differences in demographic and clinical characteristics among these groups.
Overall, 0.5%, 6.0%, and 93.6% of people were categorized into groups with high, moderate, or low likelihood of having AGHD, respectively. The proportions of females were 59.3%, 71.6%, and 50.4%, respectively. People in the high- and moderate-likelihood groups tended to be older than those in the low-likelihood group, with 58.3%, 49.0%, and 37.6% aged >50 years, respectively. Only 2.2% of people in the high-likelihood group received GH therapy as adults. The high-likelihood group had a higher incidence of comorbidities than the low-likelihood group, notably malignant neoplastic disease (standardized difference -0.42), malignant breast tumor (-0.27), hyperlipidemia (-0.26), hypertensive disorder (-0.25), osteoarthritis (-0.23), and heart disease (-0.22).
This algorithm may represent a cost-effective approach to improve AGHD detection rates by identifying appropriate patients for further diagnostic testing and potential GH replacement treatment.
成人生长激素缺乏症（AGHD）是一种诊断不足的疾病，与发病率和死亡率增加相关。识别可能从生长激素（GH）治疗中获益的人群具有挑战性，因为许多AGHD症状与衰老症状相似。我们开发了一种算法，可能有助于医疗服务提供者根据患者患AGHD的可能性对其进行分层。
该算法基于匿名的Truven Health MarketScan®理赔数据库中的数据开发，并应用于这些数据。美国共有1.35亿年龄≥18岁且在Truven数据库中有≥6个月数据的成年人。患AGHD可能性高、中、低的人群比例，以及这些组在人口统计学和临床特征方面的差异。
总体而言，分别有0.5%、6.0%和93.6%的人被归类为患AGHD可能性高、中、低的组。女性比例分别为59.3%、71.6%和50.4%。高可能性组和中可能性组的人往往比低可能性组的人年龄更大，年龄>50岁的比例分别为58.3%、49.0%和37.6%。高可能性组中只有2.2%的人成年后接受了GH治疗。高可能性组的合并症发病率高于低可能性组，尤其是恶性肿瘤疾病（标准化差异-0.42）、恶性乳腺肿瘤（-0.27）、高脂血症（-0.26）、高血压疾病（-0.25）、骨关节炎（-0.23）和心脏病（-0.22）。
该算法可能是一种经济有效的方法，通过识别适合进一步诊断测试和潜在GH替代治疗的患者来提高AGHD的检测率。
