GH deficiency in adults: an epidemiological approach

Objective: The prevalence of adult onset GH deficiency (GH-D) is poorly doc umented. Epidemiological data are now required to estimate the financial co st of GH treatment in adults. The aim of the present study was to estimate the prevalence of GH-D, from a cohort of 1652 adult patients with hypothala mo-pituitary diseases. Design: The hormonal status of all patients presenting with pituitary disea se and observed during the Bear 1994 in 15 endocrine units was retrospectiv ely analyzed, irrespective of the date of disease onset, of the nature and date of pituitary investigations, and whether or not they included specific testing of the GH axis. Of the whole population of 1652 patients, a select ed group (RG2) was chosen after exclusion of patients with active acromegal y (n = 1414). Results: GH stimulation tests had been performed in 549 patients of the RG2 group and a documented GH-D was found in 301. A relationship between the v alue of the GH peak and the number of pituitary deficits was evaluated. For instance, it was shown that 93% of patients with three deficits had GH-D, These results constituted the basis for estimating the number of GH-D in th e group of untested patients. The number of GH-D deduced from the number of established GH-D (n = 301) and from the number of GH-D hypothesized from o ther pituitary deficits (n = 406) was 707 cases. Prevalence and annual inci dence were calculated from data recorded in a referral center with a well-d efined catchment area, Marseilles (Bouches du Rhone department). We project ed a prevalence of 2638 for France and an annual incidence of 12 GH-D per m illion of the adult population.