Decrease in carotid intima-media thickness after one year growth hormone (GH) treatment in adults with GH deficiency.

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Metabolic Research

Background:

• Increased carotid arterial intima-media thickness (IMT) is observed in adults with untreated growth hormone (GH) deficiency.
• IMT is a marker of subclinical atherosclerosis and a predictor of cardiovascular events.

Purpose of the Study:

• To prospectively investigate the effect of GH replacement therapy on IMT and cardiovascular risk factors in adults with GH deficiency.
• To assess changes in IMT after 1 and 2 years of GH treatment.

Main Methods:

• A prospective study involving GH deficiency patients treated with GH (1 IU/day).
• IMT measurements were performed by a single experienced physician with a low coefficient of variation (<6.5%).
• Cardiovascular risk factors, body composition, and cardiorespiratory fitness (VO2 max) were assessed.

Main Results:

• GH treatment significantly decreased IMT after 1 year (0.78 to 0.70 mm, P < 0.001) and 2 years (stabilized at 0.70 mm, P < 0.003).
• The IMT reduction was observed in most patients (21/22) after 1 year.
• Moderate improvements in body composition (waist circumference, body fat mass) and VO2 max were noted, with minimal changes in conventional cardiovascular risk factors, except for a transient decrease in LDL cholesterol.

Conclusions:

• GH replacement therapy effectively reduces carotid IMT in adults with GH deficiency.
• The rapid and significant IMT reduction suggests a potential direct effect of GH on the arterial wall, beyond metabolic improvements.
• Further randomized trials are needed to confirm the long-term cardiovascular benefits of GH therapy.