The Effect and Potential Mechanism Analysis of Growth Hormone–Secreting Pituitary Adenomas on Thyroid Function

May 22, 2023Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

How Growth Hormone Tumors in the Pituitary May Affect Thyroid Function and Why

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Abstract

In a study of 351 patients with growth hormone-secreting pituitary adenoma, high growth hormone levels are negatively correlated with total thyroxine, free thyroxine, and thyroid-stimulating hormone.

Growth hormone levels were negatively linked to total thyroxine, free thyroxine, and thyroid-stimulating hormone.
Insulin-like growth factor-1 was positively associated with total triiodothyronine, free triiodothyronine, and free thyroxine, while negatively correlated with thyroid-stimulating hormone.
Insulin-like growth factor-binding protein-3 showed positive associations with total triiodothyronine and free triiodothyronine.
Patients with both growth hormone-secreting pituitary adenoma and diabetes mellitus exhibited significantly lower levels of free triiodothyronine, total triiodothyronine, and thyroid-stimulating hormone compared to those without diabetes.
Thyroid function declined as tumor volume increased.
Growth hormone and insulin-like growth factor-1 levels decreased with age in patients with growth hormone-secreting pituitary adenoma.

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OBJECTIVE: Current studies on the effect of high growth hormone (GH)/insulin-like growth factor (IGF)-1 on thyroid function are inconsistent. The aim was to explore the effect and potential mechanism of high GH/IGF-1 on thyroid function by analyzing the changes of thyroid function in patients with growth hormone-secreting pituitary adenoma (GHPA).

METHODS: This was a retrospective cross-sectional study. Demographic and clinical data of 351 patients with GHPA who were first admitted to Beijing Tiantan Hospital, Capital Medical University, from 2015 to 2022 were collected to analyze the relationship between high GH/IGF-1 levels and thyroid function.

RESULTS: GH was negatively correlated with total thyroxine (TT4), free thyroxine (FT4), and thyroid-stimulating hormone (TSH). IGF-1 was positively correlated with total triiodothyronine (TT3), free triiodothyronine (FT3), and FT4 and negatively correlated with TSH. Insulin-like growth factor-binding protein (IGFBP)-3 was positively correlated with TT3, FT3, and FT3:FT4 ratio. The FT3, TT3, TSH, and FT3:FT4 ratio of patients with GHPA and diabetes mellitus (DM) were significantly lower than those with GHPA but without DM. With the increase of tumor volume, thyroid function gradually decreased. GH and IGF-1 were correlated negatively with age in patients with GHPA.

CONCLUSION: The study emphasized the complex interaction between the GH and the thyroid axes in patients with GHPA and highlighted the potential effect of glycemic status and tumor volume on thyroid function.

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The Effect and Potential Mechanism Analysis of Growth Hormone–Secreting Pituitary Adenomas on Thyroid Function

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