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Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency? Data from the Dutch national registry of growth hormone treatment in adults

机译：生长激素替代疗法是否可以降低患有生长激素缺乏症的成年人的死亡率？荷兰成人生长激素治疗国家注册数据

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Context: Adults with GH deficiency (GHD) have a decreased life expectancy. The effect of GH treatment on mortality remains to be established. Objective: This nationwide cohort study investigates the effect of GH treatment on all-cause and cause-specific mortality and analyzes patient characteristics influencing mortality in GHD adults. Design, Setting, and Patients: Patients in the Dutch National Registry of Growth Hormone Treatment in Adults were retrospectively monitored (1985-2009) and subdivided into treatment (n =2229), primary (untreated, n = 109), and secondary control (partly treated, n = 356) groups. Main Outcome Measures: Standardized mortality ratios (SMR) were calculated for all-cause, malignancy, and cardiovascular disease (CVD) mortality. Expected mortality was obtained from cause, sex, calendar year, and age-specific death rates from national death and population counts. Results: In the treatment group, 95 patients died compared to 74.6 expected [SMR 1.27 (95% confidence interval, 1.04-1.56)]. Mortality was higher in women than in men. After exclusion of high-risk patients, the SMR for CVD mortality remained increased in women. Mortality due to malignancies was not elevated. In the control groups mortality was not different from the background population. Univariate analyses demonstrated sex, GHD onset, age, and underlying diagnosis as influencing factors. Conclusions: GHD men receiving GH treatment have a mortality rate not different from the background population. In women, after exclusion of high-risk patients, mortality was not different from the background population except for CVD. Mortality due to malignancies was not elevated in adults receiving GH treatment. Next to gender, the heterogeneous etiology is of influence on mortality in GHD adults with GH treatment. Copyright © 2011 by The Endocrine Society.
机译：背景：患有GH缺乏症（GHD）的成年人的预期寿命缩短。 GH治疗对死亡率的影响尚待确定。目的：这项全国性队列研究研究了GH治疗对全因病因和特定病因死亡率的影响，并分析了影响GHD成人死亡率的患者特征。设计，地点和患者：回顾性监测（1985-2009年）荷兰国家生长激素治疗国家注册中心的患者，并将其细分为治疗（n = 2229），主要（未治疗，n = 109）和次级对照（部分治疗，n = 356）组。主要观察指标：针对所有原因，恶性肿瘤和心血管疾病（CVD）的死亡率，计算标准化死亡率（SMR）。预期死亡率是根据病因，性别，日历年以及根据国家死亡率和人口计数得出的特定年龄死亡率得出的。结果：在治疗组中，有95例患者死亡，而预期为74.6例[SMR 1.27（95％置信区间，1.04-1.56）]。女性的死亡率高于男性。排除高危患者后，女性的CVD死亡率SMR仍然升高。由于恶性肿瘤导致的死亡率没有升高。在对照组中，死亡率与背景人群没有差异。单因素分析表明性别，GHD发作，年龄和基础诊断是影响因素。结论：接受GH治疗的GHD男性的死亡率与背景人群无异。在女性中，排除高危患者后，除CVD外，死亡率与背景人群无差异。在接受GH治疗的成年人中，由于恶性肿瘤导致的死亡率并未升高。除了性别，异质病因对接受GH治疗的GHD成人的死亡率也有影响。内分泌学会版权所有©2011。

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