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Recombinant GH replacement in hypopituitary adults improves endothelial cell function and reduces calculated absolute

T A M Abdu1, T A Elhadd, H Buch

  • 1Department of Medicine, School of Postgraduate Medicine, Keele University, UK.

Clinical Endocrinology
|September 10, 2004
PubMed

Insights

Growth hormone (GH) therapy improved endothelial function in adults with GH deficiency. This therapy also reduced coronary risk, primarily by lowering blood pressure and increasing HDL cholesterol.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Vascular Biology

Background:

  • Adult growth hormone deficiency (GHD) is associated with endothelial dysfunction and increased vascular disease risk.
  • GH therapy is a potential intervention for improving cardiovascular health in GHD patients.

Purpose of the Study:

  • To evaluate the effects of 12 months of GH therapy on endothelial function, inflammatory markers, and coronary risk in adults with GHD.
  • To assess changes in flow-mediated dilatation (FMD), carotid intima-media thickness (IMT), C-reactive protein (CRP), and lipid profiles.

Main Methods:

  • An open-design intervention study involving 14 adult GHD patients without diabetes, hypertension, or pre-existing vascular disease.
  • Measurements included FMD, IMT, thrombomodulin (TM), E-selectin, CRP, lipid profile, blood pressure, and anthropometric data before and after 6 and 12 months of GH therapy.
  • Coronary risk was calculated using the Framingham equation.

Main Results:

  • GH therapy significantly improved FMD (P = 0.038) and reduced systolic and diastolic blood pressure (P = 0.017 and P = 0.005, respectively).
  • High-density lipoprotein (HDL)-cholesterol increased (P = 0.001) and waist-to-hip ratio (WHR) decreased (P = 0.043), without changes in weight or BMI.
  • Ten-year absolute and relative cardiac risk significantly decreased (P = 0.009 and P = 0.002, respectively).
  • No significant changes were observed in IMT, TM, E-selectin, or CRP.

Conclusions:

  • Twelve months of GH therapy in adult GHD patients improves endothelial function, as indicated by enhanced FMD.
  • Coronary risk reduction is primarily attributed to improvements in blood pressure and HDL-cholesterol levels.
  • While biophysical endothelial function improves, biochemical markers of endothelial function and inflammation do not show significant changes.
Abstract

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