Fractures in pituitary adenoma patients from the Dutch National Registry of Growth Hormone Treatment in Adults

Purpose: The effects of growth hormone (GH) replacement therapy on fracture risk in adult GH deficient (GHD) patients with different etiologies of pituitary GHD are not well known, due to limited data. The aim of this study was to investigate characteristics and fracture occurrence at start of (baseline) and during long-term GH replacement therapy in GHD adults previously treated for Cushing’s disease (CD) or acromegaly, compared to patients with previous nonfunctioning pituitary adenoma (NFPA). Methods: From the Dutch National Registry of Growth Hormone Treatment in Adults, a nationwide surveillance study in severe GHD adults, all patients using ≥30 days of GH replacement therapy with previous NFPA (n = 783), CD (n = 180) and acromegaly (n = 65) were selected. Patient characteristics, fractures and potential influencing factors were investigated. Results: At baseline, patients with previous CD were younger, more often female and had more often a history of osteopenia or osteoporosis, whereas patients with previous acromegaly had more often received cranial radiotherapy and a longer duration between treatment of their pituitary tumor and start of adult GH replacement therapy. During follow-up, a fracture occurred in 3.8 % (n = 39) of all patients. Compared to patients with previous NFPA, only patients with previous acromegaly had an increased fracture risk after 6 years of GH replacement therapy. Conclusions: During GH replacement therapy, an increased fracture risk was observed in severe GHD adult patients previously treated for acromegaly, but not in those previously treated for CD, compared to severe GHD adult patients using GH replacement therapy because of previous NFPA. Further studies are needed to confirm these findings and to elucidate potential underlying mechanisms

Eating habits of obese patients in the Netherlands: a comparison between various subgroups and the general Dutch population.

It is still uncertain whether subgroups of obese subjects demonstrate different eating patterns. The aim of this report is to compare data on dietary intake obtained by different methods (dietary history and dietary diary) in several groups of obese patients in which the effects of weight-reducing agents were investigated. In our first and our second study, the latter part of an international multicenter study, we investigated the weight-reducing potential of lipase inhibition, a novel concept in the treatment of obesity, in healthy moderately obese subjects. In the third study, part of a national multicenter study, we investigated the effect of a serotoninergic drug (dexfenfluramine) on eating habits in moderately obese people who considered themselves snackers. Eating habits of the third group seem to be different from those of the other two groups in both men and women. These patients have a greater total energy intake due to a greater carbohydrate and fat intake. In our second study, little difference is found when results obtained by dietary history are compared with those obtained by dietary diaries. Our comparisons indicate that groups of obese patients with different patterns of eating behavior may exist and that obese snackers have a significantly greater energy intake. Therefore, various therapeutic strategies for weight reduction may be useful for patients with different types of eating behaviors. Furthermore, the methods by which data on dietary intake are obtained seem to show comparable results and therefore at least suggest accuracy. © 1995

Cortisol and reduced interhemispheric coupling between the left prefrontal and the right parietal cortex

Item does not contain fulltex

Deuterium and bromide dilution, and bioimpedance spectrometry independently show that growth hormone-deficient adults have an enlarged extracellular water compartment related to intracellular water.

Department of Human Biology, University of Maastricht, The Netherlands. GH has a strong influence on body composition. However, the effects of GH deficiency in adults on water compartments are not well understood. Therefore, extracellular water (ECW) and total body water were independently determined by deuterium and bromide dilution and by bioimpedance spectrometry in GH-deficient (GHD) adults and compared to those in controls, matched for age, sex, body weight, and height. The results show that the percent body fat was significantly (P < 0.05) higher, and total body water and intracellular water (ICW) were significantly lower in GHD adults for males, females, and both sexes combined. ECW was not significantly different between the two groups. ECW/ICW in GHD adults (0.42 +/- 0.03) was significantly (P < 0.01) higher than that in controls (0.39 +/- 0.02). There was a significant positive relation between the ECW/ICW ratio and the percent body fat. These results were confirmed by the bioimpedance spectrometry measurements

Serontonergic function, and mood in users of oral conraceptives

Item does not contain fulltex

A single administration of cortisol acutely reduces preconscious attention for fear in anxious young men.

Item does not contain fulltextChronically elevated HPA activity has often been associated with fear and anxiety, but there is evidence that single administrations of glucocorticoids may acutely reduce fear. Moreover, peri-traumatic cortisol elevation may protect against development of post-traumatic stress disorder. Hypervigilant processing of threat information plays a role in anxiety disorders and although relations with HPA functioning have been established, causality of these relations remains unclear. Presently, self-reported anxiety and response time patterns on a masked emotional Stroop task with fearful faces were measured in 20 healthy young men after double-blind, placebo-controlled oral administration of 40 mg cortisol. The masked fearful Stroop task measures vocal colornaming response latencies for pictures of neutral and fearful faces presented below the threshold for conscious perception. Results showed increased response times on trials for fearful compared to neutral faces after placebo, but this emotional Stroop effect was acutely abolished by cortisol administration. This effect was most pronounced in subjects with heightened anxiety levels. This is the first evidence showing that exogenous cortisol acutely reduces anxiety-driven selective attention to threat. These results extend earlier findings of acute fear reduction after glucocorticoid administration. This suggests interactions of HPA functioning and vigilant attention in the pathogenesis of anxiety disorders. Possible neuroendocrine mechanisms of action are discussed

Duidelijk effect van dexfenfluramine op de eetgewoonten van polikliniekpatiënten met een androïd type overgewicht en overmatige consumptie van tussendoortjes

Contains fulltext : 23746___.PDF (publisher's version ) (Open Access