title: Recombinant human GH replacement increases CD34+ cells and improves endothelial function in adults with GH deficiency.
abstract: OBJECTIVE
  Adult patients with GH deficiency (GHD) are at increased risk for cardiovascular morbidity and mortality. Endothelial function, vascular stiffness, and loss of circulating CD34+ cells are considered biomarkers for cardiovascular disease. The aim of this study was to assess vascular structure and function in relation to circulating CD34+ cells in adults with GHD before and during 1 year of recombinant human GH (rhGH) replacement.
  
  
  METHODS
  One-year intervention with rhGH.
  
  
  METHODS
  Vascular function (flow-mediated dilatation (FMD)) and structure (pulse wave velocity (PWV) and analysis) were assessed in 14 adult patients (nine men) with GHD (mean age 57 years, range 27-71 years). In addition, the number of CD34+ cells was evaluated using flow cytometric analysis. Study parameters were analyzed at baseline, and after 6 months and 1 year of rhGH replacement.
  
  
  RESULTS
  rhGH replacement increased IGF-I levels from 10.4+/-4.5 mmol/l at baseline to 18.4+/-10.1 mmol/l, and 20.5+/-8.0 mmol/l, at 6 months, and 1 year respectively (P=0.001). FMD increased from 3.5+/-1.8% to 6.0+/-2.5% and 5.1+/-2.5% during 1 year of rhGH replacement (P=0.008). There was no beneficial effect on PWV, central pulse pressure, central systolic pressure, and augmentation index. The number of CD34+ cells increased from 794.9+/-798.8 to 1270.7+/-580.1 cells/ml and to 1356.9+/-759.0 cells/ml (P=0.010).
  
  
  CONCLUSIONS
  One year of rhGH replacement in adults with GHD improves endothelial function and increases the number of circulating CD34+ cells.
authors.affiliation: Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands. a.a.van_der_klaauw@lumc.nl
authors.forename: Agatha A
authors.initials: AA
authors.lastname: van der Klaauw
authors.forename: Alberto M
authors.initials: AM
authors.lastname: Pereira
authors.forename: Ton J
authors.initials: TJ
authors.lastname: Rabelink
authors.forename: Eleonora P M
authors.initials: EP
authors.lastname: Corssmit
authors.forename: Anton-Jan
authors.initials: AJ
authors.lastname: Zonneveld
authors.forename: Hanno
authors.initials: H
authors.lastname: Pijl
authors.forename: Hetty C
authors.initials: HC
authors.lastname: de Boer
authors.forename: Johannes W A
authors.initials: JW
authors.lastname: Smit
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Romijn
authors.forename: Eelco J P
authors.initials: EJ
authors.lastname: de Koning
mesh_terms: D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism*; D001772:Blood Cell Count; D001773:Blood Cells / Q000187:drug effects / Q000378:metabolism*; D004393:Dwarfism, Pituitary / Q000188:drug therapy* / Q000378:metabolism; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000378:metabolism / Q000502:physiology; D005260:Female; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000378:metabolism; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D018952:Antigens, CD34; D011994:Recombinant Proteins; D019382:Human Growth Hormone