title: Arrest of atherosclerosis progression after interruption of GH replacement in adults with congenital isolated GH deficiency.
abstract: OBJECTIVE
  GH replacement therapy (GHRT) in adult-onset GH deficiency (AOGHD) reduces carotid intima-media thickness (IMT) and increases myocardial mass, with improvement of systolic and diastolic function. These observations have reinforced the use of GHRT on AOGHD. Conversely, we have previously reported that in adults with lifetime congenital and severe isolated GH deficiency (IGHD) due to a mutation in GHRH receptor gene (GHRHR), a 6-month treatment with depot GH increased carotid IMT, caused the development of atherosclerotic plaques, and an increase in left ventricular mass index (LVMI), posterior wall, and septal thickness and ejection fraction. Such effects persisted 12 months after treatment (12-month washout - 12 mo).
  
  
  METHODS
  We have studied the cardiovascular status (by echocardiography and carotid ultrasonography) of these subjects 60 months after completion of therapy (60-month washout - 60 mo).
  
  
  RESULTS
  Carotid IMT reduced significantly from 12 to 60 mo, returning to baseline (pre-therapy) value. The number of individuals with plaques was similar at 12 and 60 mo, remaining higher than pre-therapy. LVMI, relative posterior wall thickness, and septum thickness did not change between 12 and 60 mo, but absolute posterior wall increased from 12 to 60 mo. Systolic function, evaluated by ejection fraction and shortening fraction, was reduced at 60 mo in comparison with 12 mo returning to baseline levels. The E/A wave ratio (expression of diastolic function) decreased at 60 mo compared with both 12 mo and baseline.
  
  
  CONCLUSIONS
  In adults with lifetime congenital IGHD, the increase in carotid IMT elicited by GHRT was transitory and returned to baseline 5 years after therapy discontinuation. Despite this, the number of subjects with plaques remained stable at 60 mo and higher than at baseline.
authors.affiliation: Department of Medicine, Federal University of Sergipe, Aracaju, Brazil.
authors.forename: Vanessa P
authors.initials: VP
authors.lastname: Araujo
authors.forename: Manuel H
authors.initials: MH
authors.lastname: Aguiar-Oliveira
authors.forename: Joselina L M
authors.initials: JL
authors.lastname: Oliveira
authors.forename: Hertaline M N
authors.initials: HM
authors.lastname: Rocha
authors.forename: Carla R P
authors.initials: CR
authors.lastname: Oliveira
authors.forename: Tânia M A
authors.initials: TM
authors.lastname: Rodrigues
authors.forename: Marco A
authors.initials: MA
authors.lastname: Nunes
authors.forename: Isabella M P A
authors.initials: IM
authors.lastname: Britto
authors.forename: Roberto
authors.initials: R
authors.lastname: Ximenes
authors.forename: Jose A S
authors.initials: JA
authors.lastname: Barreto-Filho
authors.forename: Rafael A
authors.initials: RA
authors.lastname: Meneguz-Moreno
authors.forename: Rossana M C
authors.initials: RM
authors.lastname: Pereira
authors.forename: Eugênia H O
authors.initials: EH
authors.lastname: Valença
authors.forename: Luiz A
authors.initials: LA
authors.lastname: Oliveira-Neto
authors.forename: Taisa A R
authors.initials: TA
authors.lastname: Vicente
authors.forename: Amanda
authors.initials: A
authors.lastname: Blackford
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000378:metabolism* / Q000473:pathology*; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D015986:Confounding Factors, Epidemiologic; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000008:administration & dosage* / Q000172:deficiency*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors; D018608:Ultrasonography, Doppler; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology*
chemical_list: D019382:Human Growth Hormone