Does a gender related effect of growth hormone HGH replacement exist on cardiovascular risk factors cardiac morphology and performance and atherosclerosis? Results of a two-year open prospective study in young adult men and women with severe GH deficiency.
Colao A - J Clin Endocrinol Metab - 01-SEP-2005; 90(9): 5146-55
From NIH/NLM MEDLINE
NLM Citation ID:
15985481 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Journal Article
Language:
English
Author Affiliation:
Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University of Naples, via S. Pansini 5, 80131 Naples, Italy. colao@unina.it
Authors:
Colao A; Di Somma C; Cuocolo A; Spinelli L; Acampa W; Spiezia S; Rota F; Savanelli MC; Lombardi G
Abstract:
CONTEXT: HGH secretion and response to HGH replacement are gender-related. OBJECTIVE: The objective of this study was to investigate the effects of HGH deficiency (HGHD) and replacement on the cardiovascular system according to gender. DESIGN: The design was open and prospective. SETTING: The study was conducted at a university hospital. SUBJECTS: Subjects included 36 severe adult-onset HGHD patients (18 men, 20 women, aged < 45 yr); 36 gender-, age-, and body mass index-matched healthy subjects served as controls. INTERVENTIONS: Subjects received HGH replacement at a median dose of 6.5 microg/kg.d in men and 7.7 microg/kg.d in women for 2 yr. MAIN OUTCOME MEASURES: Homeostasis model assessment index, total to HDL cholesterol ratio, fibrinogen and C-reactive protein levels, left ventricular mass index, blood pressure, heart rate, diastolic filling, and systolic function at rest and at peak exercise and intima-media thickness (IMT) at common carotid arteries were measured. RESULTS: Basal prevalence and/or degree of insulin resistance, lipid alterations, compromised cardiac function, and IMT were similar in women and men. Diastolic dysfunction was more prevalent in men (61 vs. 25%, P = 0.036). After GH replacement, IGF-I levels normalized in all patients. Lipid profile, fibrinogen, and C-reactive protein levels normalized in all cases. The total to HDL ratio (P = 0.04) was higher in women than men. The homeostasis model assessment index persisted higher in HGHD patients than controls and decreased only in HGHD men (P = 0.017). Left ventricular mass index normalized during treatment in both women and men, abnormal diastolic function persisted in three women (P = 0.031), and abnormal systolic performance persisted in six women and one man (P = 0.13). IMT decreased similarly in women and men, persisting higher than in controls. Exercise performance normalized in all. CONCLUSIONS: Two-year HGH replacement has similar beneficial effects on cardiac and exercise performance and atherosclerosis in women and men with severe GHD.
Major Subjects:
- Cardiovascular System / * drug effects
- Growth Hormone / * therapeutic use
- Hormone Replacement Therapy
- Human Growth Hormone / * deficiency
- Sex Factors
- Steroid Metabolism, Inborn Errors / * drug therapy
Additional Subjects:
- Adult
- Anthropometry
- Cardiovascular Diseases / etiology
- Carotid Artery, Common / ultrasonography
- Case-Control Studies
- Echocardiography
- Exercise Test
- Female
- Humans
- Insulin-Like Growth Factor I / metabolism
- Intracranial Arteriosclerosis / ultrasonography
- Male
- Prospective Studies
- Recombinant Proteins / therapeutic use
- Research Support, Non-U.S. Gov't
- Risk Factors
Chemical Compound Name:
(Recombinant Proteins); 12629-01-5(Human Growth Hormone); 67763-96-6(Insulin-Like Growth Factor I); 9002-72-6(Human Growth Hormone)