Pituitary diseases: long-term clinical consequences
Klaauw, A.A. van der
Citation
Klaauw, A. A. van der. (2008, December 18). Pituitary diseases: long-term clinical consequences. Retrieved from https://hdl.handle.net/1887/13398
Version: Corrected Publisher’s Version
License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden Downloaded from: https://hdl.handle.net/1887/13398
Note: To cite this publication please use the final published version (if applicable).
Pituitary diseases
Long-term clinical consequences
Agatha BW.indd 1
Agatha BW.indd 1 10/29/08 3:18:17 PM10/29/08 3:18:17 PM
Omslag, lay-out en druk verzorgd door Optima Grafi sche Communicatie, Rotterdam.
Een deel van de studies beschreven in dit proefschrift werd uitgevoerd als AGIKO, met gedeeltelijke fi nanciele ondersteuning van ZonMW.
De druk van dit proefschrift werd gedeeltelijk fi nancieel ondersteund door ZonMW en het onderzoeksfonds van het Bronovo Ziekenhuis.
Agatha BW.indd 2
Agatha BW.indd 2 10/29/08 3:18:18 PM10/29/08 3:18:18 PM
Pituitary diseases: long-term clinical consequences
Proefschrift
ter verkrijging van
de graad van Doctor aan de Universiteit Leiden
op gezag van de Rector Magnifi cus prof.mr. P.F. van der Heijden, volgens besluit van het College voor Promoties
te verdedigen op donderdag 18 december 2008
klokke 11.15 uur
door
Agatha Apolonia van der Klaauw
geboren te Leiderdorp in 1980
Agatha BW.indd 3
Agatha BW.indd 3 10/29/08 3:18:18 PM10/29/08 3:18:18 PM
PROMOTIECOMMISSIE
Promotores: Prof. dr. J.A. Romijn Prof. dr. J.W.A. Smit
Copromotor: Dr. A.M. Pereira
Referent: Prof. dr. E. Fliers, Afdeling Endocrinologie en Metabolisme, AMC, Amsterdam.
Overige leden: Prof. dr. J.A. Bolk Prof. dr. H. Delemarre Dr. I.S. Farooqi Prof. dr. S. Papapoulos Prof. dr. J.M. Wit
Agatha BW.indd 4
Agatha BW.indd 4 10/29/08 3:18:22 PM10/29/08 3:18:22 PM
Contents
1. General introduction 7
Studies in patients with acromegaly
2. Uncontrolled acromegaly is associated with progressive mitral valvular regurgitation.
31
3. Increased aortic root diameters in patients with acromegaly. 43 4. Previous radiotherapy negatively infl uences quality of life during four years of
follow-up in patients cured from acromegaly.
57
5. Somatostatin analog treatment is associated with an increased sleep latency in patients with long-term biochemical remission of acromegaly.
71
6. GH defi ciency in patients irradiated for acromegaly: signifi cance of GH stimulatory tests in relation to the 24 h GH secretion.
85
7. Cardiac manifestations of growth hormone defi ciency after treatment for acromegaly: a comparison to patients with biochemical remission and controls.
99
8. Limited eff ects of growth hormone replacement in patients with growth hormone defi ciency during long-term cure of acromegaly.
115
9. Postoperative radiotherapy for acromegaly delays the circadian phase of melatonin secretion.
129
Studies in patients with growth hormone defi ciency
10. Recombinant human growth hormone replacement increases CD34+ cells and improves endothelial function in adults with growth hormone defi ciency.
141
11. Sustained eff ects of recombinant GH replacement after 7 years of treatment in adults with GH defi ciency.
155
12. The prevalence of the metabolic syndrome is increased in patients with GH defi ciency, irrespective of long-term substitution with recombinant human GH.
169
13. Administration route-dependent eff ects of estrogens on IGF-I levels during fi xed GH replacement in women with hypopituitarism.
187
14. Infl uence of the d3-growth hormone receptor isoform on short-term and long-term treatment response to growth hormone replacement in growth hormone defi cient adults.
203
Agatha BW.indd 5
Agatha BW.indd 5 10/29/08 3:18:22 PM10/29/08 3:18:22 PM
6
Contents
Studies on quality of life in patients with pituitary diseases
15. Disease specifi c impairments in quality of life during long-term follow-up of patients with diff erent pituitary adenomas.
219
16. Increased daytime somnolence despite normal sleep patterns in patients treated for nonfunctioning pituitary macroadenoma.
241
17. Patients cured from craniopharyngioma or non-functioning pituitary macroadenoma suff er similarly from increased daytime somnolence despite normal sleep patterns compared to healthy controls.
257
18. General discussion and summary 271
19. Nederlandse samenvatting 301
Curriculum Vitae 315
List of publications 316
Agatha BW.indd 6
Agatha BW.indd 6 10/29/08 3:18:23 PM10/29/08 3:18:23 PM
