title: Serum vascular endothelial growth factor (VEGF) is elevated in GH deficient adults.
abstract: OBJECTIVE
  GHD adults exhibit a number of adverse surrogate markers of vascular risk culminating in excess vascular morbidity and mortality. Vascular endothelial growth factor (VEGF) and matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of a number of vascular morbidities. Furthermore, serum levels decrease following GH replacement in GHD adults, though it remains unclear if levels are significantly elevated in untreated individuals.
  
  
  METHODS
  A cross-sectional case-control study.
  
  
  METHODS
  We measured fasting serum VEGF, MMP2, and MMP9 in 27 patients with GHD, 24 with partial GHD (GHI), and 25 sex- and age-matched controls.
  
  
  RESULTS
  GHD (483±334 vs 326±180ng/l, P=0.04), but not GHI (354±192 vs 326±180ng/l, P=n/s) adults had significantly elevated VEGF levels compared with controls. Neither MMP2, nor MMP9 levels were elevated in the patient groups. Serum VEGF levels correlated positively with LDL-cholesterol (R=0.34, P=0.004) and serum MMP9 values (R=0.36, P=0.002), and negatively with IGF-I values, however, no correlation was observed with MMP2. Multiple regression analysis with VEGF levels as the dependent variable, and age, gender, % fat mass, LDL-C, insulin and IGF-I as independent variables revealed VEGF levels to be dependent on LDL-C alone (P=0.003, R=0.36).
  
  
  CONCLUSIONS
  GHD adults have elevated VEGF levels, which correlate with MMP9 levels. Both VEGF and MMP9 are associated with vascular pathologies and may provide insight in to the pathophysiological mechanisms underlying the increased vascular morbidity and mortality observed in GHD adults.
authors: Department of Endocrinology, Christie Hospital, Manchester, UK. Robert.Murray@leedsth.nhs.uk
authors: Robert D
authors: RD
authors: Murray
authors: Harpal S
authors: HS
authors: Randeva
authors: Krzysztof C
authors: KC
authors: Lewandowski
authors: Jan
authors: J
authors: Komorowski
authors: Jeremy A
authors: JA
authors: Lawrance
authors: Judith E
authors: JE
authors: Adams
authors: Stephen M
authors: SM
authors: Shalet
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D008297:Male; D020778:Matrix Metalloproteinase 2 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D019382:Human Growth Hormone; D020778:Matrix Metalloproteinase 2; D020780:Matrix Metalloproteinase 9