The prevalence of the metabolic syndrome is increased in patients with GH deficiency, irrespective of long-term substitution with recombinant human GH.
OBJECTIVE
Many reports demonstrate improvements in cardiovascular risk factors during GH replacement (rhGH) in adult GH deficiency (GHD). However, it remains to be determined to what extent these changes translate into a reduction of increased cardiovascular morbidity and mortality. The aim of this study was to evaluate the effects of long-term rhGH replacement on the prevalence of the metabolic syndrome (MS). Design, settings, main outcome measures: The MS was scored by the National Cholesterol Education Program-Adult Treatment Panel III definition in 50 consecutive GHD patients (45 +/- 9 years of age), before and after 2 and 5 years of rhGH replacement, and the data of untreated patients were compared with the general population using data from a Dutch population-based study (n=1062, 44 +/- 8 years of age).


RESULTS
Hypertriglyceridaemia (46.0 vs 18.5%, P<0.0001), hypertension (66.0 vs 35.5%, P<0.0001) and abdominal obesity (38.0 vs 23.4%, P=0.0178) were more prevalent in untreated patients when compared with controls, resulting in a higher prevalence of the MS in patients (38.0 vs 15.7%, P<0.0001). During rhGH replacement at a mean dose of 0.5 +/- 0.2 mg/day resulting in IGF-I concentrations in the normal age-adjusted reference range, mean high-density lipoprotein cholesterol level increased compared with baseline (P<0.001). However, the prevalence of (components of) the MS did not change after 2 or 5 years of treatment with rhGH.


CONCLUSIONS
In this study, the prevalence of the MS in patients with GHD is increased compared with healthy controls, irrespective of rhGH replacement.
van der Klaauw
Agatha A
AA
Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands. a.a.van_der_klaauw@lumc.nl
Biermasz
Nienke R
NR
Feskens
Edith J M
EJ
Bos
Marieke B
MB
Smit
Johannes W A
JW
Roelfsema
Ferdinand
F
Corssmit
Eleonora P M
EP
Pijl
Hanno
H
Romijn
Johannes A
JA
Pereira
Alberto M
AM
D050153:Abdominal Fat / Q000473:pathology; D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D015228:Hypertriglyceridemia / Q000150:complications / Q000453:epidemiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012307:Risk Factors
D011994:Recombinant Proteins; D019382:Human Growth Hormone