Context: The effects of GH replacement in GH deficient (GHD) adults previously treated for acromegaly are not well known.

Objective/Design/Patients: In this single-center, open-labeled, prospective study, 10 consecutive GHD adults with cured acromegaly (A group) and 10 matched GHD adults with previous non-functioning hypopituitary disease (NF group), were included. Comparisons were made at baseline and in the responses in body composition, muscle strength, bone mass, and metabolic indices during 2-year GH replacement.

Results: At baseline, upper leg local muscle endurance and serum low density lipoprotein-cholesterol (LDL-C) concentration were more impaired in the A group. The A group contained 3 patients with hypertension, one with diabetes mellitus (DM) type 2, and one with hyperlipidemia. The NF group had only one patient with hypertension. There were no significant between-group differences in the responses to the GH therapy. Body composition and serum lipid pattern improved in both groups without any deterioration of glucose homeostasis. At study end, no difference remained between the two groups in any variable. During the 2-year treatment, one patient had a myocardial infarction and two had cerebral infarctions in the A group whereas no vascular event occurred in the NF group.

Conclusions: GHD patients with previous acromegaly have an impaired cardiovascular risk profile and decreased local muscle endurance as compared with other GHD patients. Two-year GH replacement eliminated these differences but vascular events occurred more frequently in the A group. Therefore, GHD patients with cured acromegaly will benefit from GH replacement but careful monitoring of cardiovascular status is needed.