title: Two years of growth hormone replacement therapy in a group of patients with Sheehan's syndrome.
abstract: To investigate the effects of GH replacement on lipid profile, carotid artery intima-media thickness (IMT), glucose metabolism and visceral fat in patients with Sheehan's syndrome, ten patients, mean age 44.8+/-9.5 yr, compared with 10 controls matched for age and body mass index were studied. Total cholesterol, Triglycerides (TG), HDL-c, LDL-c, Apolipoprotein A and B (apoA and apoB) and Lipoprotein (a), serum IGF-1, ultrasonography of the carotid arteries, oral glucose tolerance test (OGTT), HOMA insulin resistance index, insulin sensitivity index (ISI)-composite and abdominal CT scan were performed. When compared to a control group, patients presented lower HDL concentrations (p=0.05) and 2-h OGTT insulin levels (p<0.04) and increased TG levels (p<0.04). After 24 months of GH replacement a reduction in the relation ApoB/ApoA (p=0.04) was observed, as well as an increase in HDL (p<0.004). A decrease in carotid artery IMT and in visceral fat over time was found, p<0.03 and p<0.04 respectively, though without any significant differences during post hoc comparisons of means, which may be explained by the small number of cases studied, but there was a tendency, p=0.08 and p=0.09 respectively. The 2-h OGTT insulin levels increased (p<0.02) as well as the prevalence of glucose intolerance (prevalence = 42.8%, p<0.05). GH replacement therapy promoted favorable effects on carotid artery IMT, lipid profile and visceral fat in patients with Sheehan's syndrome. On the other hand, patients developed abnormal glucose tolerance probably due to an increase in insulin resistance, demonstrated by higher insulin levels, despite favorable changes in body composition.
authors.affiliation: Service of Endocrinology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil. wellbs@terra.com.br
authors.forename: Débora Vieira
authors.initials: DV
authors.lastname: Soares
authors.forename: Luciana Diniz Carneiro
authors.initials: LD
authors.lastname: Spina
authors.forename: Rosane Resende
authors.initials: RR
authors.lastname: de Lima Oliveira Brasil
authors.forename: Priscila Marise
authors.initials: PM
authors.lastname: Lobo
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Salles
authors.forename: Claúdia Medina
authors.initials: CM
authors.lastname: Coeli
authors.forename: Flávia Lúcia
authors.initials: FL
authors.lastname: Conceição
authors.forename: Mario
authors.initials: M
authors.lastname: Vaisman
mesh_terms: D000328:Adult; D001823:Body Composition / Q000187:drug effects; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D008076:Cholesterol, HDL / Q000097:blood; D004305:Dose-Response Relationship, Drug; D005947:Glucose / Q000378:metabolism; D013006:Growth Hormone / Q000627:therapeutic use*; D020249:Hormone Replacement Therapy; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000378:metabolism; D008137:Longitudinal Studies; D008875:Middle Aged; D011446:Prospective Studies; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
chemical_list: D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D013006:Growth Hormone; D005947:Glucose