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Effects of adult growth hormone deficiency and replacement therapy on the cardiometabolic risk profile
Balázs Ratku1,2,3, Veronika Sebestyén1,2, Annamária Erdei4
1Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary.
Insights
Adult growth hormone deficiency (AGHD) presents a significant cardiometabolic risk. While hormone replacement helps, it doesn't resolve all issues, necessitating careful cardiovascular monitoring for affected patients.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Adult growth hormone deficiency (AGHD) is a rare endocrine disorder with adverse cardiometabolic risk.
- Associated factors include endothelial dysfunction, inflammation, oxidative stress, and hypovitaminosis D, contributing to premature atherosclerosis.
Purpose of the Study:
- To review the cardiometabolic risk profile in AGHD patients.
- To discuss novel biomarkers and diagnostic techniques for cardiovascular risk assessment.
- To provide recommendations for managing cardiovascular health in AGHD.
Main Methods:
- Literature review of studies on AGHD and cardiovascular risk.
- Analysis of contributing factors beyond traditional risk factors.
- Discussion of growth hormone replacement therapy's effects.
Main Results:
- AGHD is linked to endothelial dysfunction, inflammation, altered adipokines, oxidative stress, and hypovitaminosis D.
- Growth hormone replacement therapy shows benefits but doesn't eliminate all cardiometabolic abnormalities.
- Novel biomarkers may improve individual risk evaluation.
Conclusions:
- AGHD patients have a complex cardiometabolic risk profile requiring comprehensive assessment.
- Close cardiovascular monitoring and a low threshold for detailed evaluation are recommended.
- Further research into specific guidelines for cardiovascular assessment in AGHD is warranted.
Abstract:
Adult growth hormone deficiency (AGHD) is considered a rare endocrine disorder involving patients with childhood-onset and adult-onset growth hormone deficiency (AoGHD) and characterized by adverse cardiometabolic risk profile. Besides traditional cardiovascular risk factors, endothelial dysfunction, low-grade inflammation, impaired adipokine profile, oxidative stress and hypovitaminosis D may also contribute to the development of premature atherosclerosis and higher cardiovascular risk in patients with AGHD. Growth hormone replacement has been proved to exert beneficial effects on several cardiovascular risk factors, but it is also apparent that hormone substitution in itself does not eliminate all cardiometabolic abnormalities associated with the disease. Novel biomarkers and diagnostic techniques discussed in this review may help to evaluate individual cardiovascular risk and identify patients with adverse cardiometabolic risk profile. In the absence of disease-specific guidelines detailing how to assess the cardiovascular status of these patients, we generally recommend close follow-up of the cardiovascular status as well as low threshold for a more detailed evaluation.
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