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Growth hormone replacement does not increase serum prostate-specific antigen in hypopituitary men over 50 years
C W le Roux1, P J Jenkins, S L Chew
1Department of Endocrinology, St Bartholomew's and the Royal London School of Medicine and Dentistry, St Bartholomew's Hospital, London EC1A 7BE, UK.
Objective:
Epidemiological studies have shown an increased risk for prostate carcinoma in men with serum IGF-I in the upper part of the age-related reference range. Recombinant human GH (rhGH) is widely used in patients with GH deficiency, usually raising the serum IGF-I levels into the normal range: safety surveillance is therefore mandatory, with particular regard to neoplasia. The aim was to examine whether rhGH replacement in hypopituitary adults is associated with changes in serum prostate-specific antigen (PSA) as a surrogate marker of changes in prostatic growth.
Design And Methods:
A prospective longitudinal study was used with a median follow-up of 22 (range 2.5-32) months, in which 41 men aged over 50 years with adult onset hypopituitarism and GH deficiency during rhGH replacement were examined. Serum PSA and IGF-I were measured at baseline and at latest follow-up.
Results:
Mean serum PSA remained unchanged during rhGH replacement, with a median follow-up of 2 years. No correlation was found between the individual changes in serum IGF-I and changes in serum PSA.
Conclusions:
These data are reassuring thus far regarding the safety of GH replacement in relation to the prostate in this patient group.