title: One-year GH replacement therapy reduces early cardiac target organ damage (TOD) in adult GHD patients.
abstract: Hypopituitarism reduces life expectancy and increases the risk of cardiovascular and cerebrovascular diseases, as well as death. Abnormalities in the cardiovascular system may be independently related to GH deficiency (GHD). The aim of this study was to prospectively investigate coronary flow reserve and diastolic function in GHD adult patients at diagnosis and after 1 year of GH replacement therapy. As control group, an age- and sex-matched population was chosen. All patients and controls were non-smokers, non-diabetic, and normotensive, with no history of vascular disease. 14 patients with adult-onset GHD and 17 controls represent the two study groups. Anthropometric data, blood pressure, lipid profile, glycosylated hemoglobin (HbA1c) and IGF-I plasma levels, coronary flow reserve (CFR), and LV diastolic function (evaluated by E/A) were collected in all subjects before and after 12 months of GH replacement therapy. Compared with controls, systolic and diastolic blood pressure and LDL cholesterol levels were significantly higher at baseline and return, comparable to controls after 1 year of GH replacement (GHRT). GHD patients showed a blunted CFR at baseline (P < 0.001) and a significant improvement after GHRT, returning to values comparable with those recorded in the control group. In addition, after therapy a significant (P < 0.001) improvement in E/A was recorded. One year of GH therapy improves CFR and E/A in the patient population analyzed, thereby encouraging the early start of GHRT.
authors.affiliation: Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy. mara.boschetti@unige.it.|Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy. mara.boschetti@unige.it.
authors.forename: Mara
authors.initials: M
authors.lastname: Boschetti
authors.affiliation: Cardiology Unit, Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Agosti
authors.affiliation: Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Albanese
authors.affiliation: Cardiology Unit, Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Casalino
authors.affiliation: Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Teti
authors.affiliation: Cardiology Unit, Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Bezante
authors.affiliation: Cardiology Unit, Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Brunelli
authors.affiliation: Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy.|Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Albertelli
authors.affiliation: Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy.|Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ferone
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D003326:Coronary Circulation / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006321:Heart / Q000503:physiopathology*; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D006442:Glycated Hemoglobin; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D008055:Lipids
keywords: Cardiovascular disease; Coronary flow reserve; Diastolic function; Growth hormone deficiency; IGF-I