| Protein C and protein S changes in GH-deficient adults on r-HGH replacement therapy: correlations with PAI-1 and t-PA plasma levels. | |
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MedLine Citation:
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PMID: 20920820 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: In the rat liver, growth hormone (GH) affects the synthesis of vitamin-K-dependent factors, including Protein C (prot.C) and protein S (prot.S), two natural anticoagulants that prevent hypercoagulable states. Adults with GH deficiency (GHD) are at risk of thrombotic events. High circulating levels of PAI-1 and t-PA, that reflect hypercoagulable states, may contribute to such risk. In GHD adults on replacement therapy with recombinant human GH (r-HGH), %Δ PAI-1 and %Δ t-PA are related to %Δ insulin changes. OBJECTIVES: To evaluate changes in vitamin-K-dependent factors in GHD on r-HGH replacement. METHODS: In 60 GHD adults, to relate plasma levels of vitamin-K-dependent factors with those of PAI-1, t-PA and insulin before and after 6-month (6-mo) replacement therapy with r-HGH. RESULTS: After 6-mo r-HGH replacement, %Δ insulin enhancements occurred in 36/60 subjects. PAI-1, t-PA, Prot.C, Prot.S and FVIIact did not change in them. In the 24/40 subjects that experienced %Δ insulin reductions, Prot.C (p=0.025), Prot.S (p=0.031) and FVIIact (p=0.049) decreased significantly. PAI-1 (p=0.019) and t-PA antigen (p=0.009) behaved similarly. In a multivariate analysis, %∆ PAI-1 (β=0.436, p<0.01) was the strongest predictor of %∆ prot.S, wheras %∆ t-PA (β=0.385, p<0.008) and %∆ insulin (β=0.429, p<0.004) were the strongest predictors of %∆ prot.C. In all cases, regardless of %Δ insulin changes, FII, FVII Ag and FIX levels did not change from baseline. CONCLUSIONS: In GHD adults on r-HGH replacement, changes in vitamin-K-dependent factors reflect a subtle adaptation of the natural anticoagulant system to PAI-1 and t-PA changes, via the response of insulin to r-HGH. |
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Authors:
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Matteo Nicola Dario Di Minno; Salvatore Pezzullo; Vittorio Palmieri; Carolina Di Somma; Roberta Lupoli; Domenico Valle; Gaetano Lombardi; Giovanni Di Minno |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Thrombosis research Volume: 126 ISSN: 1879-2472 ISO Abbreviation: Thromb. Res. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-03 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: United States |
Other Details:
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Languages: eng Pagination: e434-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Department of Clinical and Experimental Medicine, Reference Centre for Coagulation Disorders, Federico II University, Naples, Italy. dario.diminno@hotmail.it |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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