Growth hormone treatment on atherosclerosis: results of a 5-year open, prospective, controlled study in male patients with severe growth hormone deficiency.

Abstract

BACKGROUND:

Severe GH deficiency (GHD) is associated with, increased cardiovascular risk and intima-media thickness (IMT) at major arteries.

OBJECTIVE:

The objective of the study was to investigate the 5-yr effects of GH replacement on common carotid IMT and insulin resistance syndrome (IRS) (at least two of the following: triglycerides levels > or = 1.7 mmol/liter, high-density lipoprotein-cholesterol levels < or = 1.0 mmol/liter, blood pressure above 130/85 mm Hg, fasting glucose 6.1-7 or 2 hr after glucose 7.7-11.1 mmol/liter).

DESIGN:

This was an interventional, open, prospective, controlled study.

PATIENTS:

Patients included 35 men with severe GHD and 35 age-matched healthy men as controls.

INTERVENTION:

All patients received standard replacement therapy; GH replacement was added in 22 patients (group A) and refused by 13 others (group B).

MEASUREMENTS:

Five-year changes in IMT and IRS prevalence were measured.

RESULTS:

At baseline, IMT was higher in the patients with (P < 0.001) and without IRS (P = 0.004) than in controls. Eighteen patients (51.4%) and two controls (5.7%; P < 0.0001) had IRS. At study end, use of lipid-lowering drugs (92.3, vs. 13.6 and 34.3%, P < 0.0001), glucose-lowering drugs (69.2 vs. 31.4 and 22.7%; P = 0.016), and antihypertensive drugs (61.5 vs. 20.0 and 4.5%; P < 0.0001) was higher in group B patients than controls and group A patients. IGF-I levels normalized in all group A patients and remained lower than -1 sd score in 77% of group B patients. IMT significantly decreased only in group A and significantly increased in controls and nonsignificantly in group B patients. IRS prevalence significantly reduced only in group A patients.

CONCLUSIONS:

Severely hypopituitary GHD men have more frequently increased IMT at common carotid arteries and IRS than controls. After 5 years, only in GH replaced patients, IMT and prevalence of IRS decreased.

• Authors: Annamaria Colao, Carolina Di Somma, Stefano Spiezia, Silvia Savastano, Francesca Rota, Maria Cristina Savanelli, Gaetano Lombardi
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 93 Issue 9 Pg. 3416-24 (Sep 2008) ISSN: 0021-972X [Print] United States
• PMID: 18593773 (Publication Type: Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Human Growth Hormone

Topics

• Adult
• Algorithms
• Atherosclerosis (complications, drug therapy, epidemiology, pathology)
• Carotid Artery, Common (diagnostic imaging, pathology)
• Dwarfism, Pituitary (complications, drug therapy, pathology)
• Follow-Up Studies
• Hormone Replacement Therapy
• Human Growth Hormone (deficiency, therapeutic use)
• Humans
• Hypopituitarism (complications, drug therapy, pathology)
• Male
• Metabolic Syndrome (complications, epidemiology)
• Middle Aged
• Prevalence
• Time Factors
• Tunica Media (diagnostic imaging, pathology)
• Ultrasonography