title: Congenital growth hormone (GH) deficiency and atherosclerosis: effects of GH replacement in GH-naive adults.
abstract: BACKGROUND
  GH deficiency (GHD) in adults is associated with increased abdominal adiposity and systolic blood pressure, total and low-density lipoprotein cholesterol, and C-reactive protein.
  
  
  METHODS
  We have studied the effects of 6-month GH replacement therapy in 20 adult members of a large Brazilian kindred with lifelong severe and isolated GHD due to a homozygous mutation in GHRH receptor gene (46 +/- 14.5 yr; 122 +/- 7.7 cm; 36.7 +/- 5.4 kg; 10 men). Subjects were studied at baseline, after 6-month bimonthly depot GH injections (Nutropin Depot; Genentech, Inc., South San Francisco, CA) [post GH (pGH)], and after 6- and 12-month washout.
  
  
  RESULTS
  Despite modest trough serum IGF-I increase, GH replacement therapy caused a decrease in skinfolds and in waist-hip ratio, with a rebound increase at 12 months. Total and low-density lipoprotein cholesterol were reduced pGH and returned to baseline at 6 months. High-density lipoprotein cholesterol increased pGH, but at 12 months was lower than baseline. A progressive increase in left ventricular mass index, posterior wall, and septum thickness occurred from pGH to 12 months, and of carotid intima-media thickness, from 6 to 12 months. Individuals were 6, 16, and 52 times more likely to have an atherosclerotic carotid plaque at pGH, 6 and 12 months, respectively, when compared with baseline.
  
  
  CONCLUSIONS
  In patients with lifetime isolated GHD, 6-month treatment with GH has reversible beneficial effects on body composition and metabolic profile, but it causes a progressive increase in intima-media thickness and in the number of atherosclerotic carotid plaques.
authors.affiliation: Department of Endocrinology, Federal University of Sergipe, Aracaju, SE Brazil 49060-100.
authors.forename: Joselina L M
authors.initials: JL
authors.lastname: Oliveira
authors.forename: Manuel H
authors.initials: MH
authors.lastname: Aguiar-Oliveira
authors.forename: Argemiro
authors.initials: A
authors.lastname: D'Oliveira
authors.forename: Rossana M C
authors.initials: RM
authors.lastname: Pereira
authors.forename: Carla R P
authors.initials: CR
authors.lastname: Oliveira
authors.forename: Catarine T
authors.initials: CT
authors.lastname: Farias
authors.forename: José A
authors.initials: JA
authors.lastname: Barreto-Filho
authors.forename: Fernando D
authors.initials: FD
authors.lastname: Anjos-Andrade
authors.forename: Celi
authors.initials: C
authors.lastname: Marques-Santos
authors.forename: Adão C
authors.initials: AC
authors.lastname: Nascimento-Junior
authors.forename: Erica O
authors.initials: EO
authors.lastname: Alves
authors.forename: Francielle T
authors.initials: FT
authors.lastname: Oliveira
authors.forename: Viviane C
authors.initials: VC
authors.lastname: Campos
authors.forename: Roberto
authors.initials: R
authors.lastname: Ximenes
authors.forename: Amanda
authors.initials: A
authors.lastname: Blackford
authors.forename: Giovanni
authors.initials: G
authors.lastname: Parmigiani
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
mesh_terms: D000328:Adult; D000886:Anthropometry; D050197:Atherosclerosis / Q000139:chemically induced* / Q000453:epidemiology* / Q000473:pathology; D001794:Blood Pressure / Q000502:physiology; D002339:Carotid Arteries / Q000473:pathology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003692:Delayed-Action Preparations; D004452:Echocardiography; D015444:Exercise / Q000502:physiology; D005260:Female; D013006:Growth Hormone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D006339:Heart Rate / Q000502:physiology; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D003692:Delayed-Action Preparations; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone