Growth Hormone Therapy
Compared to patients with non-functional pituitary adenomas, those with SS are significantly younger at pituitary disorder onset, have significantly lower insulin-like growth factor I levels and more severe GH deficiency. GH replacement therapy (GHRT) in patients with SS has been shown to have beneficial effects on quality of life (QoL), body composition and lipid profile. However, no improvement in bone mineral density BMD was noted in a study of 14 severely GH-deficient patients with SS after 18 months of GHRT.[51–54] Golgeli et al. studied the impact of GHD and GH replacement therapy on cognitive function using P300 event related potential (ERP) latencies and found an impairment of cognitive abilities due to severe GHD in patients with SS and an improvement of cognitive function after 6 months of physiological GHRT.[55] In one study, GH-deficient females with SS had more non-rapid eye movement (NREM), particularly in stage 4 sleep, less rapid eye movement (REM) sleep and also less sleep efficiency when compared to healthy controls. After 6 months of GHRT, there was no significant difference in sleep parameters between them.[56] Increased cardiovascular mortality has been observed in patients with hypopituitarism including SS, and an adverse lipid profile, elevated body mass index (BMI), increased waist circumference, abnormal body composition, and a high risk of hypertension have been described.