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Cardiovascular effects of growth hormone replacement therapy in hypopituitary adults
S A Beshyah1, M Shahi, E Skinner
1Unit of Metabolic Medicine, St Mary's Hospital and Medical School, London, UK.
Insights
Biosynthetic human growth hormone (GH) replacement in hypopituitary adults significantly increased serum IGF-I levels and exercise time. This study investigated GH
Area of Science:
- Endocrinology
- Cardiology
Background:
- Hypopituitarism in adults can lead to various health complications.
- Growth hormone (GH) deficiency affects cardiac structure and function.
- Conventional replacement therapy may not fully address these deficits.
Purpose of the Study:
- To investigate the effects of biosynthetic human GH replacement on cardiac structure and function in hypopituitary adults.
- To assess the impact of GH therapy on exercise capacity and cardiovascular parameters.
Main Methods:
- Prospective, randomized, double-blind, placebo-controlled trial.
- 36 GH-deficient hypopituitary adults received either GH (17 patients) or placebo (19 patients) for 6 months.
- Assessments included echocardiography, Doppler ultrasound, exercise ECG, and serum IGF-I levels.
Main Results:
- Significant increase in serum IGF-I levels in the GH group compared to placebo (p < 0.0001).
- Exercise time significantly increased in the GH group (p < 0.01), but not in the placebo group.
- No significant changes in resting or peak exercise heart rate or blood pressure were observed.
Conclusions:
- Biosynthetic human GH replacement therapy improves exercise capacity in hypopituitary adults.
- GH therapy effectively increases IGF-I levels, a key indicator of GH activity.
- Further research is needed to fully elucidate the long-term cardiac effects.
Abstract:
In the present study the effects of replacement with biosynthetic human growth hormone (GH) in a large group of hypopituitary adults on cardiac structure and function were investigated. Thirty-six GH-deficient, hypopituitary patients (17 males and 19 females; aged 19-67 years) on conventional replacement therapy without GH were studied. Twenty-nine of the patients had acquired hypopituitarism in adult life, mainly due to pituitary tumours. The design of the study was a prospective, randomized, double-blind placebo-controlled trial for 6 months. Growth hormone (17 patients) was given in a daily dose of 0.02-0.05 IU/kg body wt sc (or a placebo, 19 patients) according to the patients' tolerance. Other pituitary replacement treatment was unchanged. Resting and exercise electrocardiography using the Bruce protocol, two-dimensional echocardiography, Doppler ultrasound scanning and serum insulin-like growth factor I (IGF-I) were assessed at 0 and 6 months. Resting blood pressure was measured at 0, 1, 3 and 6 months. Serum IGF-I increased significantly on GH treatment (mean +/- SD) GH: 293 +/- 197 vs placebo: 82 +/- 40 micrograms/l; p < 0.0001 at 6 months). Exercise time increased significantly on GH but not on placebo (GH: 8.45 +/- 3.16 to 9.38 +/- 2.42 min.sec, p < 0.01; placebo 9.08 +/- 4.35 to 9.50 +/- 4.14 min.sec, NS), although the change was not significantly different between the two. There was no change in the heart rate or the blood pressure either at rest or at the peak of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)