Intima-media thickness in cardiovascularly asymptomatic hypopituitary adults with growth hormone deficiency: relation to body mass index, gender, and other cardiovascular risk factors.
OBJECTIVE
Increased cardiovascular mortality and carotid atherosclerosis have been observed in hypopituitary patients with untreated GH deficiency (GHD), but results are contradictory and relations to cardiovascular risk factors are not clear. The aim of this study was to investigate intima-media thickness (IMT) in relation to cardiovascular risk factors in adults with GHD.


METHODS
Cross-sectional observational study of 21 men and 13 women with GHD, but without cardiovascular disease, compared to two healthy control groups matched for age, sex and smoking habits. One control group was matched for body mass index (BMI) and the other group was nonobese.


METHODS
IMT of the carotid and femoral arteries, blood pressure, blood samples and anthropometric data.


RESULTS
Patients had 12% thicker composite carotid IMT [(IMT of common carotid artery + IMT of bulb)/2] compared to nonobese controls (P = 0.022), but IMT was not different compared to BMI-matched controls. Femoral IMT did not differ between patients and controls. Patients had higher waist : hip ratio (WHR), heart rate, serum triglycerides and fasting insulin concentrations in combination with lower high-density lipoprotein (HDL) cholesterol and smaller low-density lipoprotein (LDL) peak particle size compared to both nonobese and to BMI-matched controls. This cardiovascular risk pattern was more pronounced in female patients than in male patients compared to their gender controls. Carotid IMT was related to age, serum cholesterol, LDL cholesterol and smoking in the patient group. Only age was independently related to carotid IMT in multivariate analysis.


CONCLUSIONS
These results indicate that high BMI in GH-deficient patients contribute to their increased intima-media thickness. However, several cardiovascular risk factors are present in this patient group independent of their increased BMI, especially in women.
Leonsson
Maria
M
Research Centre for Endocrinology and Metabolism, Sahlgrenska University Hospital, Göteborg, Sweden.
Hulthe
Johannes
J
Oscarsson
Jan
J
Johannsson
Gudmundur
G
Wendelhag
Inger
I
Wikstrand
John
J
Bengtsson
Bengt-Ake
BA
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000378:metabolism; D017536:Carotid Artery, Common; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005263:Femoral Artery; D013006:Growth Hormone / Q000172:deficiency* / Q000378:metabolism; D006801:Humans; D007018:Hypopituitarism / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000378:metabolism / Q000473:pathology*; D012307:Risk Factors; D012723:Sex; D012737:Sex Factors; D012907:Smoking; D018709:Statistics, Nonparametric; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D008078:Cholesterol, LDL; D013006:Growth Hormone; D002784:Cholesterol