Effects of growth hormone replacement therapy on metabolic and cardiac parameters, in adult patients with childhood-onset growth hormone deficiency.
OBJECTIVE
We evaluated metabolic and cardiac parameter changes with GH-therapy.


METHODS
Sixteen adults with childhood-onset hypopituitarism receiving pituitary hormone replacement, except GH-replacement, were assessed at baseline and after 6 and 12 months of GH-replacement. Sixteen healthy adults matched for sex, age, weight, height, body mass index, and body surface area served as the control group to compare cardiac function in both groups.


RESULTS
All patients had GH-deficiency. After 12 months, serum insulin-like growth factor-1 levels normalized. Basal glucose or insulin levels had no alterations. The low/high density lipoprotein-cholesterol ratio decreased (3.18+/-1.32 x 2.17+/-0.8, p<0.001). Percent lean body mass increased (69.9+/-5.5 x 78.4+/-8.1%), and percent fat body mass decreased (30.1+/-5.5 x 21.6+/-8.1%) (both, p<0.001). Before treatment, patients had decreased left ventricular (LV) echocardiographic morphologic indexes, which were corrected (initial versus 12 months): interventricular septal thickness (0.68+/-0.06 x 0.78+/-0.06 cm), LV posterior wall thickness (0.69+/-0.07 x 0.78+/-0.05 cm), and LV mass index (58.9+/-11.0 x 71.1+/-9.4 g/m(2)) (all, p<0.001). Exercise capacity improved, as assessed by oxygen consumption (7.84+/-1.44 x 9.67+/-1.74 METS, p<0.001).


CONCLUSIONS
GH-replacement seems to reduce cardiovascular risks in adults with childhood-onset GH-deficiency.
Endocrine Unit, University of São Paulo Medical School, São Paulo-SP, Brazil. pumba@osite.com.br
Raquel S
RS
Jallad
Bernardo
B
Liberman
Caio B
CB
Vianna
Marcelo L C
ML
Vieira
Jose A F
JA
Ramires
Mirta
M
Knoepfelmacher
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition; D002319:Cardiovascular System / Q000187:drug effects*; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D004562:Electrocardiography; D015444:Exercise; D005260:Female; D006130:Growth Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism*; D020249:Hormone Replacement Therapy; D006728:Hormones / Q000097:blood; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male
D001786:Blood Glucose; D006728:Hormones; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D002784:Cholesterol