Common carotid intima-media thickness in human growth hormone HGH-deficient adolescents: a prospective study after HGH withdrawal and restarting HGH replacement.
Colao A - J Clin Endocrinol Metab - 01-MAY-2005; 90(5): 2659-65
From NIH/NLM MEDLINE
NLM Citation ID:
15713715 (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; Rota F; Di Maio S; Salerno M; Klain A; Spiezia S; Lombardi G
Abstract:
We prospectively investigated the risk of early atherosclerosis, by classical cardiovascular risk factors and intima-media thickness (IMT) at the common carotid arteries, in 23 adolescents diagnosed as HGH deficient (HGHD) during childhood and in 23 healthy sex-, age-, and BMI-matched controls. Measurements were performed in all subjects before stopping HGH replacement. Because the diagnosis of HGHD had been confirmed in 15 of the 23 adolescents, the protocol changed according to the diagnosis as follows: measurements were repeated after 6 months of HGH withdrawal and 6 months of HGH reinstitution in the 15 with HGHD, and after 6 and 12 months of HGH withdrawal, measurements were also taken in the eight non-HGHD subjects. Serum IGF-I levels were in the normal range for age in all patients before HGH withdrawal. When compared with controls, before HGH withdrawal, HGHD adolescents had reduced high-density lipoprotein cholesterol levels and increased total/high-density lipoprotein cholesterol ratio, fibrinogen, low-density lipoprotein cholesterol, and glucose levels; non-HGHD adolescents had increased glucose, insulin, and homeostasis model assessment score. IMT at the common carotid arteries was similar in HGHD and controls (0.52 +/- 0.03 vs. 0.55 +/- 0.06 mm; P = 0.23) and was higher in non-HGHD than in controls (0.62 +/- 0.03 vs. 0.54 +/- 0.06 mm; P = 0.01). In HGHD adolescents, 6 months of GH treatment withdrawal and 6 months of HGH treatment reinstitution modified IGF-I levels, lipid profile, and insulin resistance but not IMT or systolic and diastolic peak velocities at the common carotid arteries. In non-HGHD subjects, 12 months of GH treatment withdrawal significantly decreased IGF-I levels, IMT (to 0.54 +/- 0.06 mm; P < 0.001 vs. baseline), systolic and diastolic peak velocities, and improved insulin resistance. In conclusion, the discontinuation of HGH in confirmed HGHD adolescents is not followed by significant alterations of the common carotid arteries, despite the profound negative alterations of the lipid profile. In adolescents who were not confirmed to have HGHD, IMT was increased while on HGH therapy and normalized when they were taken off of HGH.
Major Subjects:
- Carotid Artery, Common / * pathology
- Hormone Replacement Therapy
- Human Growth Hormone / * deficiency / therapeutic use
- Tunica Intima / * pathology
Additional Subjects:
- Adolescent
- Adult
- Female
- Humans
- Insulin-Like Growth Factor I / analysis
- Male
- Nitric Oxide / biosynthesis
- Prospective Studies
- Research Support, Non-U.S. Gov't
Chemical Compound Name:
10102-43-9(Nitric Oxide); 12629-01-5(Human Growth Hormone); 67763-96-6(Insulin-Like Growth Factor I)