Document Detail


Short-term effects of growth hormone (GH) treatment or deprivation on cardiovascular risk parameters and intima-media thickness at carotid arteries in patients with severe GH deficiency.
MedLine Citation:
PMID:  15671089     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To explore early effects of GH 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 GH deficiency. At study entry, the patients were randomized into two groups (A and B); group A (n = 17) received appropriate replacement therapy including GH at standard doses for 6 months and then were withdrawn from GH for the subsequent 6 months; group B (n = 17) received appropriate replacement therapy excluding GH for 6 months with the addition of GH in the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 GH 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 GH 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 GH replacement has beneficial effects whereas 6 months of GH deprivation has detrimental effects on cardiovascular risk factors and atherosclerosis. These findings support the indication for GH replacement in severe GH deficiency adult patients.
Authors:
Annamaria Colao; Carolina Di Somma; Francesca Rota; Rosario Pivonello; Maria Cristina Savanelli; Stefano Spiezia; Gaetano Lombardi
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-01-25
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  90     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-07     Completed Date:  2005-05-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2056-62     Citation Subset:  AIM; IM    
Affiliation:
Department of Molecular and Clinical Endocrinology and Oncology, "Federico II" University of Naples, via S. Pansini 5, 80131 Naples, Italy. colao@unina.it
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MeSH Terms
Descriptor/Qualifier:
Adult
C-Reactive Protein / analysis
Carotid Arteries / pathology*
Cholesterol, HDL / blood
Cross-Over Studies
Female
Growth Hormone / therapeutic use*
Hormone Replacement Therapy*
Human Growth Hormone / deficiency*
Humans
Insulin-Like Growth Factor I / analysis
Male
Middle Aged
Risk Factors
Tunica Media / pathology*
Chemical
Reg. No./Substance:
0/Cholesterol, HDL; 12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I; 9002-72-6/Growth Hormone; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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