Effects of growth hormone and insulin-like growth factor-1 on cardiac hypertrophy of hypertensive patients.
OBJECTIVE
Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) interfere with cardiac mass (left ventricular mass; LVM) development. We investigated the role of the GH/IGF-1 axis on LVM and ventricular geometry in a group of 230 never-treated hypertensive patients.


METHODS
Partition values for left ventricular hypertrophy (LVH) were 125 g/m2 for both women and men. Insulin resistance was estimated by the homeostasis model assessment (HOMA) index.


RESULTS
A significant inverse correlation was observed between IGF-1 and both fasting insulin (r = -0.249; P < 0.0001) and GH (r = -0.218; P < 0.0001). Systolic blood pressure (157.3 +/- 13.6 versus 149.4 +/- 12.8 mmHg; P < 0.001), fasting insulin (17.4 +/- 8.5 versus 11.4 +/- 6.0 microU/l; P < 0.0001), HOMA (4.4 +/- 2.3 versus 2.9 +/- 1.6; P < 0.0001) and GH (1.0 +/- 1.0 versus 0.4 +/- 0.5 ng/ml; P < 0.0001) were significantly higher in patients with LVH; on the contrary, IGF-1 values (119.1 +/- 47.8 versus 160.1 +/- 75.5 ng/ml; P < 0.0001) were higher in patients without LVH. In a logistic regression analysis, the strongest independent predictors of LVH were GH [relative risk (RR) = 2.078; 95% confidence interval (CI) = 1.364-3.163], HOMA (RR = 1.345; 95% CI = 1.133-1.596), IGF-1 (RR = 0.993; 95% CI = 0.998-0.999) and systolic blood pressure (RR = 1.036; 95% CI = 1.013-1.060). IGF-1 showed an opposite trend in patients with eccentric and concentric hypertrophy.


CONCLUSIONS
Present data demonstrate that the increase in LVM prevalent in human essential hypertension is directly associated with serum GH levels and inversely related to circulating IGF-1.
Sesti
Giorgio
G
Unit of Internal Medicine, Department of Experimental and Clinical Medicine G. Salvatore, University Magna Graecia of Catanzaro, Italy.
Sciacqua
Angela
A
Scozzafava
Angela
A
Vatrano
Marco
M
Angotti
Elvira
E
Ruberto
Carmen
C
Santillo
Elpidio
E
Parlato
Giuseppe
G
Perticone
Francesco
F
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged
D007328:Insulin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I