{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T06:44:26Z","timestamp":1778049866403,"version":"3.51.4"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,10]]},"abstract":"\nBackground<\/jats:title>\nPatients with hypopituitarism have an increased mortality. The aim of this study was to investigate comorbidities including cerebral infarction, type 2 diabetes mellitus (T2DM) and malignant tumors in patients with non-functioning pituitary adenomas (NFPA) with and without growth hormone replacement therapy (GHRT).<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nObservational cohort study in patients with NFPA within the western region of Sweden. Subjects were identified through the National Patient Registry and followed between 1987 and 2014. Patient records were reviewed and standardized incidence ratios (SIRs) with 95% CIs for comorbidities were calculated.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nIn total, 426 patients were included, 206 with GHRT and 219 without. Median (range) follow-up time for patients with and without GHRT was 12.2 (0\u201324) and 8.2 (0\u201327) years, respectively. Mean\u2009\u00b1\u2009s.d.<\/jats:sc> BMI was 28.5\u2009\u00b1\u20094.5 and 26.5\u2009\u00b1\u20094.4 for patients with and without GHRT, respectively (P<\/jats:italic>\u2009<\u20090.001). Incidence of cerebral infarction was increased (SIR: 1.39; 95% CI: 1.03\u20131.84; P<\/jats:italic>\u2009=\u20090.032), with no difference between patients with and without GHRT. SIR for T2DM in patients not receiving GHRT was increased (1.65; 1.06\u20132.46; P<\/jats:italic>\u2009=\u20090.018), whereas the incidence in patients receiving GHRT was not (0.99; 0.55\u20131.63; P<\/jats:italic>\u2009=\u20090.99). The incidence of malignant tumors was not increased, either in patients with or without GHRT.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe incidence of cerebral infarction is increased in patients with NFPA irrespective of GHRT. Patients without GHRT had an increased risk of T2DM, whereas patients with GHRT had a normal incidence of T2DM, despite having higher BMI. Incidence of malignant tumors was not increased. Thus, long-term GHRT seems to be safe regarding risk of comorbidities.<\/jats:p>\n<\/jats:sec>","DOI":"10.1530\/eje-18-0370","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T10:35:17Z","timestamp":1532601317000},"page":"229-237","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":14,"title":["Comorbidities in patients with non-functioning pituitary adenoma: influence of long-term growth hormone replacement"],"prefix":"10.1093","volume":"179","author":[{"given":"Casper","family":"Hammarstrand","sequence":"first","affiliation":[{"name":"1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"2Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"2Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivia","family":"Bengtsson","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"2Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ing-Liss","family":"Bryngelsson","sequence":"additional","affiliation":[{"name":"3Department of Occupational and Environmental Medicine, \u00d6rebro University Hospital, \u00d6rebro, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gudmundur","family":"Johannsson","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"2Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel S","family":"Olsson","sequence":"additional","affiliation":[{"name":"1Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, G\u00f6teborg, Sweden"},{"name":"2Department of Endocrinology, Sahlgrenska University Hospital, G\u00f6teborg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","reference":[{"key":"ref91","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/0140-6736(93)92664-F","article-title":"Aortic distensibility in growth hormone deficient adults","volume":"341","year":"1993","journal-title":"Lancet"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/S0360-3016(99)00159-5","article-title":"The incidence of cerebrovascular accidents in patients with pituitary adenoma","volume":"45","year":"1999","journal-title":"International Journal of Radiation Oncology, Biology, Physics"},{"key":"ref421","doi-asserted-by":"crossref","first-page":"4843","DOI":"10.1210\/jc.2016-2221","article-title":"Exploring inpatient hospitalizations and morbidity in patients with adrenal insufficiency","volume":"101","year":"2016","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1530\/EJE-16-0450","article-title":"Life expectancy in patients with pituitary adenoma receiving growth hormone replacement","volume":"176","year":"2017","journal-title":"European Journal of Endocrinology"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1210\/jc.2015-1475","article-title":"Excess mortality in women and young adults with nonfunctioning pituitary adenoma: a swedish nationwide study","volume":"100","year":"2015","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"3151","DOI":"10.1210\/jc.2011-1215","article-title":"Does growth hormone replacement therapy reduce mortality in adults with growth hormone deficiency? 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