Changes in endothelial dysfunction and associated cardiovascular disease morbidity markers in GH-IGF axis pathology.
Arterial endothelial dysfunction is an early event in the pathogenesis of atherosclerosis and predisposes individuals to the deposition of unstable atherosclerotic plaques. It can also lead to increased arterial stiffness, which is an accepted cause of increased arterial pulse wave velocity (APWV). Endothelial dysfunction is reversed by recombinant human growth hormone (rhGH) therapy in patients with growth hormone (GH) deficiency (GHD), favorably influencing the risk for atherogenesis. Endogenous human growth hormone (hGH), secreted by the anterior pituitary, and levels of insulin-like growth factor-I (IGF-I), produced in response to hGH stimulation of the liver, peak during early adulthood, but decline throughout adulthood. It is suspected that low-grade inflammatory cardiovascular pathophysiologic markers such as homocysteine, nitric oxide, C-reactive protein (CRP), and fibrinogen and plasminogen activator inhibitor along with changes in lipid and glucose metabolism may all contribute to GHD-associated metabolic and cardiovascular complications. These effects are associated with increased APWV, but are attenuated by rhGH therapy in GHD. GH replacement increases IGF-I levels and reduces CRP and large-artery stiffness. Reviews of rhGH in the somatopause have not been overtly favorable. Whereas reviews of rhGH/rhIGF-I combinations in GH resistance are more positive than those for rhGH alone, their combined use in the somatopause is limited. Senescent individuals may benefit from such a combination.
Graham
Michael R
MR
The Newman Centre for Sport and Exercise Research, Newman University College, Birmingham, UK. drgraham.ac.uk@live.co.uk
Evans
Peter
P
Thomas
Non-Eleri
NE
Davies
Bruce
B
Baker
Julien S
JS
D000375:Aging / Q000378:metabolism; D001158:Arteries / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000150:complications* / Q000378:metabolism / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency* / Q000502:physiology / Q000627:therapeutic use; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008954:Models, Biological; D011674:Pulse; D011994:Recombinant Proteins / Q000627:therapeutic use
D015415:Biomarkers; D018836:Inflammation Mediators; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I