The Growth Hormone Level And Clinical Features In Nonfunctioning Pituitary Adenoma Postopertive Patients

Background Pituitary tumor surgery and radiotherapy is the one most important reason of adult growth hormone(GH) deficiency(AGHD) . AGHD often cause muscle quality reduce, strength decline, endocrine and lipid metabolic abnormal, cardiovascular events increase and the quality of life decline , while cause psychological problem. Research abroad show that the GH of the postoperative pituitary patients tumor insufficient , can not maintain the patient's normal physiological function. In domestic, physicians pay more attention on the hormones (adrenal hormones, thyroid hormone,gonad hormone) level of the postoperative pituitary adenoma patients,however less attention on weather growth-hormone deficiency,and the level of growth hormone, clinical characteristics and hormone supplementary treatment .Objective to test the GH-hormone of the nonfunctional pituitary postoperative patients and summarize clinical characteristics, investigate quality of life and psychological state, and providing theoretical basis for GH applicating in adult growth hormone deficiency patients.Methods patients were in line with 0riginal Selection Standard in the outpatients of our hospital Twenty-nine patients were selected into trials group (GHD–group) by insulin tolerance test. The people who were healthy volunteers were selected into normal control group(NC-group). All the people were performed the drug probocation test,Insulin was intravenous injected with 0.10-0.15U/Kg,detected the fingertip capillary blood glucose levers at -30minuts before injection and 0,30,45,60,90minuts after injection,at the same time , their levers of growth hormone(GH) and blood glucose were also detected at -30,0,30,45,60,90,120 minuts,kept observing the reactions during the whole test.The people who were healthy volunteers were selected into normal control group(NC-group).The two group were tested by endocrine hormone examination(tetraiodothyronine,hebin,adrenal hormone),blood routine examination,liver, renal function,blood lipid,OGTT (oral glucose tolerance test),body height and weight,body mass index (BMI),waist hip ratio (WHR),FAT%,skin thickness,left and right hands grip strength.We evaluate the quality of life and the mental state by the analysis of Quality of Life Scale (QOL-AGHDA ,Holmes et al, 1995), Zung Self-Rating Anxiety Scale (SAS) and Zung self-rating depression scale (SDS) .Results: 1,All the patients(thirty-one) in line with the primary selection standards finished the examination of ITT smoothly. They show hypoglycemic reaction and the lowest level of Glucose ,which was lower than 2.2mmol/L or lower than 50% of basic level. ,it indicated the test was effective. Twenty-nine patients show the GH deficiency, twenty-three patents show that the GH peak level was lower than 3μg/L, and the GH curves was in low and flat condition, which show the severe shortage of GH. Two patients whose GH peak levels were higher than 5μg/L show normal.2,The peak points in severe GH shortage group focus on the level between 30 to 60 minute, and the relative GH shortage group focus on the level between 45 to 60 minute .The GH level of patients in severe GH shortage group was in lower state .3,The patients in GHD group show decreased in weight,appetite,the Quality of sleep,libido and anamnesis which show no specificity.4,FAT% in GHD group increased significantly(27.082±6.20 VS 23.43±3.76,P=0.009)and the thickness of subcutaneous Fat was higher slightly than NC group(31.04±8.44 VS 29.55±8.32)which show no statistical difference. WHR in GHD group was higer than NC group (0.86±0.053 VS 0.83±0.76 P<0.05).5,Triglyceride in GHD group increased significantly than NC group. (3.46±2.28 VS 1.07±0.37 P<0.01).Blood total cholesterol was higher slightly than NC group which show no statistical difference. High density lipoprotein was lower slightly than NC group which show no statistical difference.6,The hand grip strengths in GHD group were lower than NC group Comparing with Corresponding gender and hands.(P<0.05).7,Scores of QOL-AGHDA in GHD group were higher significantly than NC group(7.96±3.35 VS4.57±2.22 )and show statistical difference. The scores in group which the Growth Hormone is in severe shortage increased significantly than NC group(P<0.05) and the scores in relative shortage group increased slightly which show no statistical difference.8,There were twenty patients in anxiety state who take 20% parts in GHD group ,and 12 who was 31.5% in NC group .the scores in GHD group were higher significantly than NC group and show statistical difference ( P< 0.05).9,there were thirteen patients in depression who take 44.82% parts in GHD group and nine who was 25.7% in NC group .the scores in GHD group were higher than NC group but show no statistical difference( P>0.05).Conclusions: 1,Most of non-functioning pituitary adenoma postoperative patients are in severe shortage of Growth Hormone and should be paid more attention and monitored. 2,clinical symptoms of non-functioning pituitary adenoma patients after operation are no specificient. There are some characteristic Pathophysiological changes ,such as the FAT% and Triglyceride increase, the Lipid Metabolism and the body activity ability decrease . 3,The scores of QOL-AGHDA in non-functioning pituitary adenoma patients after operation are higher ,and the quality of life decreased severely .these patients are often afflicted by Anxiety and depression ,shoud be detected and treated earierly to promote the life quality..