Cardiovascular effects of growth hormone replacement therapy in hypopituitary adults.
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)
Beshyah
S A
SA
Unit of Metabolic Medicine, St Mary's Hospital and Medical School, London, UK.
Shahi
M
M
Skinner
E
E
Sharp
P
P
Foale
R
R
Johnston
D G
DG
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004452:Echocardiography; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D012739:Gonadal Steroid Hormones / Q000627:therapeutic use; D013006:Growth Hormone / Q000494:pharmacology / Q000627:therapeutic use*; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D019382:Human Growth Hormone; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007018:Hypopituitarism / Q000188:drug therapy*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D013974:Thyroxine / Q000627:therapeutic use
D012739:Gonadal Steroid Hormones; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D013974:Thyroxine; D006854:Hydrocortisone