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High fibrinogen and plasminogen activator inhibitor activity in growth hormone-deficient adults
J O Johansson1, K Landin, L Tengborn
1Department of Medicine, Sahlgrenska Hospital, Göteborg, Sweden.
Insights
Growth hormone (GH) deficiency in adults increases cardiovascular disease risk due to higher PAI-1 activity and fibrinogen levels. These factors may contribute to atherothrombotic propensity and vascular disease development.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Metabolic Research
Background:
- Hypopituitary patients on standard hormone replacement therapy (excluding growth hormone) exhibit elevated cardiovascular disease mortality.
- Growth hormone (GH) deficiency is a potential contributor to premature vascular disease in these patients.
Purpose of the Study:
- To investigate cardiovascular disease risk factors in GH-deficient adults undergoing routine hormone replacement therapy.
- To compare specific hemostatic, metabolic, and anthropometric markers between GH-deficient adults and matched healthy controls.
Main Methods:
- Study included 20 GH-deficient adults (on replacement therapy except GH) and 20 age-, sex-, and BMI-matched healthy controls.
- Measurements included waist-to-hip ratio, serum triglycerides, plasminogen activator inhibitor (PAI-1) activity, fibrinogen, blood glucose, blood pressure, insulin, and cholesterol.
Main Results:
- GH-deficient subjects showed significantly higher waist-to-hip ratio, serum triglycerides, PAI-1 activity, and fibrinogen levels compared to controls.
- Lower blood glucose levels were observed in the GH-deficient group.
- No significant differences were found in blood pressure, insulin, or cholesterol levels between the groups.
Conclusions:
- GH deficiency is associated with an increased atherothrombotic risk profile, characterized by elevated PAI-1 and fibrinogen.
- These hemostatic and metabolic alterations may play a crucial role in the pathogenesis of cardiovascular disease in hypopituitary patients.
Abstract:
Hypopituitary patients on routine replacement therapy except growth hormone (GH) have an increased risk of death from cardiovascular diseases compared with healthy subjects. Untreated GH deficiency might explain the premature death from vascular disease. Plasminogen activator inhibitor (PAI-1) activity, fibrinogen, insulin, blood lipid, and blood pressure levels were studied in 20 GH-deficient adults (10 men, 10 women) 50 +/- 11 years old with routine hormone replacement therapy (except GH) and compared with 20 healthy control subjects matched for sex, age, and body mass index. GH-deficient subjects had a higher waist-to-hip circumference ratio (P < .001), serum triglycerides (P < .02), PAI-1 activity (13.2 +/- 10.6 versus 6.8 +/- 4.8 U/mL [P < .05]), and fibrinogen (3.2 +/- 0.7 versus 2.4 +/- 0.6 g/L [P < .001]) and lower blood glucose (P < .05) compared with control subjects. Blood pressure, insulin, and cholesterol levels were similar. The aberrations found in this study might contribute to an increased atherothrombotic propensity and play a role in the pathogenesis of cardiovascular disease.