title: Brazilian adult individuals with untreated isolated GH deficiency do not have accelerated subclinical atherosclerosis.
abstract: GH and its principal mediator IGF1 have important effects on metabolic and cardiovascular (CV) status. While acquired GH deficiency (GHD) is often associated with increased CV risk, the consequences of congenital GHD are not known. We have described a large group of patients with isolated GHD (IGHD) due to a homozygous mutation (c.57+1G>A) in the GH releasing hormone receptor gene, and shown that adult GH-naïve individuals have no evidence of clinically evident premature atherosclerosis. To test whether subclinical atherosclerosis is anticipated in untreated IGHD, we performed a cross-sectional study of 25 IGHD and 27 adult controls matched for age and gender. A comprehensive clinical and biochemical panel and coronary artery calcium scores were evaluated by multi-detector tomography. Height, weight, IGF1, homeostasis model assessment of insulin resistance, creatinine and creatininekinase were lower in the IGHD group. Median and interquartile range of calcium scores distribution was similar in the two groups: IGHD 0(0) and control 0(4.9). The vast majority of the calcium scores (20 of 25 IGHD (80%) and 18 of 27 controls (66.6%)) were equal to zero (difference not significant). There was no difference in the calcium scores classification. None of IGHD subjects had minimal calcification, which were present in four controls. Three IGHD and four controls had mild calcification. There were two IGHD individuals with moderate calcification and one control with severe calcification. Our study provides evidence that subjects with congenital isolated lifetime and untreated severe IGHD do not have accelerated subclinical coronary atherosclerosis.
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Ursula M M
authors.initials: UM
authors.lastname: Costa
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Carla R P
authors.initials: CR
authors.lastname: Oliveira
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA salvator@jhmi.edu.
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: José A S
authors.initials: JA
authors.lastname: Barreto-Filho
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Viviane C
authors.initials: VC
authors.lastname: Campos
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Francielle T
authors.initials: FT
authors.lastname: Oliveira
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Ivina E S
authors.initials: IE
authors.lastname: Rocha
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Joselina L M
authors.initials: JL
authors.lastname: Oliveira
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Wersley A
authors.initials: WA
authors.lastname: Silva
authors.affiliation: Division of CardiologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyFederal University of Sergipe, Aracaju, SE 49060-100, BrazilDivision of EndocrinologyDiabetes and Metabolism, The Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, Maryland 21287, USA.
authors.forename: Manuel H
authors.initials: MH
authors.lastname: Aguiar-Oliveira
keywords: calcium score; coronary atherosclerosis; isolated growth hormone deficiency; multi-detector CT
references.citation: N Engl J Med. 2008 Mar 27;358(13):1336-45
references.pmid: 18367736
references.citation: J Clin Endocrinol Metab. 2006 Jun;91(6):2093-9
references.pmid: 16522693
references.citation: J Clin Endocrinol Metab. 2007 Dec;92(12):4664-70
references.pmid: 17911170
references.citation: JAMA. 2001 Jul 11;286(2):180-7
references.pmid: 11448281
references.citation: Atherosclerosis. 2006 Aug;187(2):378-84
references.pmid: 16242697
references.citation: J Clin Endocrinol Metab. 2002 May;87(5):2018-23
references.pmid: 11994335
references.citation: J Am Coll Radiol. 2014 Jan;11(1):12-9
references.pmid: 24316232
references.citation: Circulation. 2002 Aug 20;106(8):939-44
references.pmid: 12186797
references.citation: J Am Coll Cardiol. 2009 Jun 16;53(24):2273-9
references.pmid: 19520251
references.citation: PLoS One. 2011 Feb 16;6(2):e17063
references.pmid: 21359226
references.citation: Endocr Rev. 1995 Feb;16(1):63-86
references.pmid: 7758433
references.citation: J Clin Endocrinol Metab. 1999 Mar;84(3):917-23
references.pmid: 10084571
references.citation: J Clin Endocrinol Metab. 2014 Sep;99(9):3285-9
references.pmid: 24926956
references.citation: Lancet. 1990 Aug 4;336(8710):285-8
references.pmid: 1973979
references.citation: J Clin Endocrinol Metab. 2010 Feb;95(2):714-21
references.pmid: 19965916
references.citation: J Clin Endocrinol Metab. 2011 Oct;96(10):3151-9
references.pmid: 21849531
references.citation: Endocrine. 2014 Sep;47(1):191-7
references.pmid: 24272598
references.citation: Clin Endocrinol (Oxf). 2002 Dec;57(6):713-7
references.pmid: 12460319
references.citation: J Am Coll Cardiol. 2007 May 8;49(18):1860-70
references.pmid: 17481445
references.citation: Clin Endocrinol (Oxf). 1997 Jan;46(1):75-81
references.pmid: 9059561
references.citation: J Am Coll Cardiol. 2009 Jan 27;53(4):345-52
references.pmid: 19161884
references.citation: J Clin Endocrinol Metab. 2003 Aug;88(8):3664-7
references.pmid: 12915652
references.citation: J Clin Endocrinol Metab. 2013 Apr;98(4):1466-75
references.pmid: 23457412
references.citation: Front Endocrinol (Lausanne). 2011 Sep 27;2:32
references.pmid: 22654802
references.citation: J Clin Endocrinol Metab. 2005 Mar;90(3):1864-70
references.pmid: 15585563
references.citation: J Clin Endocrinol Metab. 2012 Mar;97(3):1013-9
references.pmid: 22170707
references.citation: Lancet. 2001 Feb 10;357(9254):425-31
references.pmid: 11273062
references.citation: Clin Endocrinol (Oxf). 2008 Sep;69(3):347-58
references.pmid: 18462260
references.citation: Vasc Health Risk Manag. 2010 Aug 09;6:603-11
references.pmid: 20730016
references.citation: Endocrine. 2016 Feb;51(2):317-22
references.pmid: 26100788
references.citation: J Clin Endocrinol Metab. 2010 Feb;95(2):693-8
references.pmid: 20016047
references.citation: J Am Coll Cardiol. 2005 Aug 2;46(3):457-63
references.pmid: 16053958
references.citation: Physiol Rev. 2013 Apr;93(2):571-98
references.pmid: 23589828
references.citation: Curr Cardiol Rep. 2013 May;15(5):358
references.pmid: 23529290
references.citation: J Clin Endocrinol Metab. 2006 Oct;91(10):3954-61
references.pmid: 16895963
references.citation: Int J Cardiovasc Imaging. 2013 Oct;29(7):1595-602
references.pmid: 23653248
references.citation: Eur J Endocrinol. 2012 Jun;166(6):1069-77
references.pmid: 22457236
references.citation: Endocr Pract. 2003 Jan-Feb;9(1):64-76
references.pmid: 12917095
references.citation: J Clin Endocrinol Metab. 2014 Jan;99(1):18-29
references.pmid: 24217903
references.citation: J Clin Endocrinol Metab. 1999 Nov;84(11):4118-26
references.pmid: 10566659