Short term effects of human growth hormone HGH treatment or deprivation on cardiovascular risk parameters and intima media thickness at carotid arteries in patients with severe HGH deficiency.
Colao A - J Clin Endocrinol Metab - 01-APR-2005; 90(4): 2056-62
From NIH/NLM MEDLINE
NLM Citation ID:
15671089 (PubMed)
Full Source Title:
Journal of Clinical Endocrinology and Metabolism
Publication Type:
Clinical Trial; Journal Article; Randomized Controlled Trial
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; Rota F; Pivonello R; Savanelli MC; Spiezia S; Lombardi G
Abstract:
To explore early effects of HGH treatment or deprivation on cardiovascular risk factors and carotid intima-media thickness (IMT), we designed this randomized, cross-over study in 34 adult patients with severe HGH deficiency. At study entry, the patients were randomized into two groups (A and B); group A (n = 17) received appropriate replacement therapy including HGH at standard doses for 6 months and then were withdrawn from HGH for the subsequent 6 months; group B (n = 17) received appropriate replacement therapy excluding HGH for 6 months with the addition of HGH in the subsequent 6 months. After the first 6 months, we observed a significant increase in IGF-I levels and of high-density lipoprotein (HDL)-cholesterol together with a significant decrease in diastolic blood pressure, the total/HDL-cholesterol ratio, and C-reactive protein in the patients in group A, whereas vascular parameters did not significantly change. In the patients in group B, none of the parameters studied significantly changed. After 6 months of HGH withdrawal in the patients in group A, a significant decrease in IGF-I levels, a significant increase in the total/HDL-cholesterol ratio and C-reactive protein, and a trend toward an impairment of carotid IMT and peak velocities were observed. In the patients in group B, the addition of HGH to the standard replacement induced a significant increase in IGF-I levels together with a decrease in systolic and diastolic blood pressure, total cholesterol and total/HDL-cholesterol ratio, and C-reactive protein, and an increase in HDL-cholesterol levels with a trend toward an improvement of vascular parameters. At the end of the study, mean IMT was significantly lower than at baseline both in group A (from 0.88 +/- 0.28 to 0.85 +/- 0.27 mm, P = 0.0003) and in group B (from 0.83 +/- 0.21 to 0.80 +/- 0.20 mm, P = 0.003). In conclusion, 6 months of HGH replacement has beneficial effects whereas 6 months of HGH deprivation has detrimental effects on cardiovascular risk factors and atherosclerosis. These findings support the indication for HGH replacement in severe HGH deficiency adult patients.
Major Subjects:
- Carotid Arteries / * pathology
- Growth Hormone / * therapeutic use
- Hormone Replacement Therapy
- Human Growth Hormone / * deficiency
- Tunica Media / * pathology
Additional Subjects:
- Adult
- C-Reactive Protein / analysis
- Cross-Over Studies
- Female
- Humans
- Insulin-Like Growth Factor I / analysis
- Lipoproteins, HDL Cholesterol / blood
- Male
- Middle Aged
- Research Support, Non-U.S. Gov't
- Risk Factors
Chemical Compound Name:
(Lipoproteins, HDL Cholesterol); 12629-01-5(Human Growth Hormone); 67763-96-6(Insulin-Like Growth Factor I); 9002-72-6(Human Growth Hormone); 9007-41-4(C-Reactive Protein)