Prevalence and risk of complications in untreated patients with adult growth hormone deficiency.

A large cohort of untreated AGHD patients was identified from a Japanese claims database over a 14-year period.

• 8,809 untreated patients with AGHD were identified from April 2008 to September 2022
• 3,430 patients were included in the 2020 prevalence analysis
• Data were sourced from the Medical Data Vision claims database using Japanese local disease codes mapped to ICD-10 codes
• The study focused specifically on patients without GH replacement therapy (GHRT)

The prevalence of diabetes mellitus was substantially higher in untreated AGHD patients than in the Japanese general population.

• Diabetes mellitus prevalence was 9.3% in the AGHD population versus 3.6% in the Japanese general population in 2020
• Comparison was age- and sex-adjusted
• Diabetes mellitus was identified as a significant risk factor for multiple other complications

The prevalence of osteoporosis was markedly elevated in untreated AGHD patients compared to the general population.

• Osteoporosis prevalence was 4.8% in the AGHD population versus 1.3% in the Japanese general population in 2020
• Female sex was identified as a significant risk factor specifically for osteoporosis
• Comparison was age- and sex-adjusted

The prevalence of dyslipidemia was markedly higher in untreated AGHD patients than in the general population.

• Dyslipidemia prevalence was 22.0% in the AGHD population versus 3.9% in the Japanese general population in 2020
• Diabetes mellitus was identified as a significant risk factor for dyslipidemia in the Cox proportional hazard model
• Comparison was age- and sex-adjusted

Age was a significant risk factor for most AGHD-related complications.

• Risk factors were evaluated by Kaplan-Meier curves and a Cox proportional hazard model
• Age was identified as a significant risk factor for most complications
• Female sex was specifically identified as a risk factor for osteoporosis

Diabetes mellitus was a significant risk factor for multiple serious complications including cardiovascular outcomes and all-cause death in untreated AGHD patients.

• Diabetes mellitus was a significant risk factor for dyslipidemia, ischemic heart disease, cerebrovascular disease, and all-cause death
• Risk factors were assessed using a Cox proportional hazard model
• This finding highlights the compounding effect of comorbid diabetes in AGHD patients

Untreated AGHD patients had higher prevalence of metabolic complications than the general population despite no difference in related risk factors.

• The elevated complication prevalence occurred despite no identified difference in related risk factors between the AGHD population and the general population
• GHRT use was low in the study population
• The authors concluded that comprehensive treatment approaches including GHRT need to be considered to alleviate the risk of complications