Cardiovascular effects of growth hormone in adult hemodialysis patients: results from a randomized controlled trial.
OBJECTIVE
The high morbidity and mortality rates in hemodialysis (HD) patients are due, at least in part, to their increased risk for cardiovascular diseases (CVD). This prospective study evaluated the effect of growth hormone (GH) on a number of CVD risk markers in adult patients on HD.


METHODS
139 HD patients were randomized to one of three GH doses or to placebo. Change from baseline in lean body mass (LBM), CVD risk markers (e.g. lipid profile, plasma homocysteine, inflammatory markers, blood pressure, IGF-I, IGFBP-3 and echocardiography) and correlations with serum IGF-I levels and body mass index were evaluated.


RESULTS
LBM increased in GH-treated groups compared with placebo (p < 0.001 pooled GH groups vs. placebo). IGF-I (p = 0.0027) and serum high-density-lipoprotein cholesterol levels (p = 0.038) increased with GH treatment. Serum low-density-lipoprotein cholesterol showed a trend to reduction. IGF-I was negatively correlated with plasma homocysteine levels (p = 0.01) and systolic blood pressure (p < 0.0001). Logistic regression analysis showed that interleukin-6, ghrelin and hematocrit values were significant determinants of all-cause mortality. Left ventricular mass was unchanged from baseline in GH-treated groups.


CONCLUSIONS
In adult HD patients, GH treatment had a predominantly beneficial effect on CVD risk markers.
Kober
Lars
L
Department of Cardiology, Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. lk@heart.dk
Rustom
Rana
R
Wiedmann
Jonas
J
Kappelgaard
Anne-Marie
AM
El Nahas
Meguid
M
Feldt-Rasmussen
Bo
B
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006710:Homocysteine / Q000097:blood; D019382:Human Growth Hormone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome
D015415:Biomarkers; D012709:Serum Albumin; D006710:Homocysteine; D019382:Human Growth Hormone