Growth hormone treatment on atherosclerosis: results of a 5-year open, prospective, controlled study in male patients with severe growth hormone deficiency.
BACKGROUND
Severe GH deficiency (GHD) is associated with, increased cardiovascular risk and intima-media thickness (IMT) at major arteries.


OBJECTIVE
The objective of the study was to investigate the 5-yr effects of GH replacement on common carotid IMT and insulin resistance syndrome (IRS) (at least two of the following: triglycerides levels > or = 1.7 mmol/liter, high-density lipoprotein-cholesterol levels < or = 1.0 mmol/liter, blood pressure above 130/85 mm Hg, fasting glucose 6.1-7 or 2 hr after glucose 7.7-11.1 mmol/liter).


METHODS
This was an interventional, open, prospective, controlled study.


METHODS
Patients included 35 men with severe GHD and 35 age-matched healthy men as controls.


METHODS
All patients received standard replacement therapy; GH replacement was added in 22 patients (group A) and refused by 13 others (group B).


METHODS
Five-year changes in IMT and IRS prevalence were measured.


RESULTS
At baseline, IMT was higher in the patients with (P < 0.001) and without IRS (P = 0.004) than in controls. Eighteen patients (51.4%) and two controls (5.7%; P < 0.0001) had IRS. At study end, use of lipid-lowering drugs (92.3, vs. 13.6 and 34.3%, P < 0.0001), glucose-lowering drugs (69.2 vs. 31.4 and 22.7%; P = 0.016), and antihypertensive drugs (61.5 vs. 20.0 and 4.5%; P < 0.0001) was higher in group B patients than controls and group A patients. IGF-I levels normalized in all group A patients and remained lower than -1 sd score in 77% of group B patients. IMT significantly decreased only in group A and significantly increased in controls and nonsignificantly in group B patients. IRS prevalence significantly reduced only in group A patients.


CONCLUSIONS
Severely hypopituitary GHD men have more frequently increased IMT at common carotid arteries and IRS than controls. After 5 years, only in GH replaced patients, IMT and prevalence of IRS decreased.
Colao
Annamaria
A
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, via S. Pansini 5, 80131 Naples, Italy. colao@unina.it
Di Somma
Carolina
C
Spiezia
Stefano
S
Savastano
Silvia
S
Rota
Francesca
F
Savanelli
Maria Cristina
MC
Lombardi
Gaetano
G
D000328:Adult; D000465:Algorithms; D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology; D004393:Dwarfism, Pituitary / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005500:Follow-Up Studies; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D013997:Time Factors; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
D019382:Human Growth Hormone