Retinal studies in patients with hyperglycaemia, hypoinsulinaemia and hyperlipidaemia associated with hypopituitarism.

Abstract

ABSTRACT Twenty-four patients who had a 10-year history of hypopituitarism resulting from treated chromophobe adenoma, without known family history of diabetes, were studied during oral glucose tolerance (GTT), arginine infusion, and insulin tolerance (ITT) tests. All patients were receiving thyroid and cortisone replacement. Serum immunoreactive growth hormone (HGH) was subnormal in all patients compared with normal subjects during both arginine infusion and ITT tests (P < 0.001). Although 9 of this hypopituitary group were diabetic, all patients showed a subnormal peak immunoreactive insulin rise during an arginine infusion test and subnormal insulinogenic index during an oral glucose tolerance test, when compared with normal subjects in the same age range. Fasting plasma triglycerides were elevated in the majority of patients, serum cholesterol in 8 while free fatty acids were high in all patients. Hyperglycaemia, hypoinsulinaemia, hyperlipidaemia and low growth hormone levels were not associated with any of the clinical signs of vascular disease frequently seen in diabetic patients.