Emerging cardiovascular risk factors/markers such as proinflammatory cytokines , C-reactive protein , and adipokines are also increased in GHD patients .
Increased cardiovascular morbidity and mortality have also been reported in GHD .
GH treatment has been shown to improve both traditional and emerging cardiovascular risk factors and markers .
The GHD population may be considered at high cardiovascular risk , and GH substitution may be expected to bring an added value to patients with hypopituitarism in terms of cardiovascular protection .
CONTEXT GH deficiency ( GHD ) of the adult is a clinical condition characterized by the presence of several traditional and emerging cardiovascular risk factors that can significantly increase cardiovascular morbidity and mortality .
It is still an open issue whether GH replacement is able not only to improve cardiovascular risk factors but also to decrease cardiovascular morbidity and mortality .
EVIDENCE SYNTHESIS In untreated GHD , cardiovascular risk is increased due to abnormal lipid profile ( increased total and low-density lipoprotein cholesterol , increased triglycerides , and reduced high-density lipoprotein cholesterol ) and impaired glucose metabolism .
One year of GH replacement therapy with a fixed low-dose regimen improves body composition, bone mineral density and lipid profile of GH-deficient adults.
OBJECTIVE We have studied the effects on body composition and metabolism of a fixed low dose of growth hormone ( GH ) , 0.6 IU ( 0.2 mg)/day , administered for 12 months to GH-deficient ( GHD ) adults . DESIGN AND METHODS Prospect i ve open-label study , using 18 GHD patients ( 11 women , 7 men ; aged 21 - 58 years ) . All investigations were performed at baseline and after 12 months . Body composition was determined by dual energy X-ray absorptiometry . RESULTS Total body fat decreased ( -1.74+/-2.87 % ) and lean body mass ( LBM ) increased ( 1.27+/-2.08 kg ) after therapy ( P < 0.05 ) . Changes in truncal fat did not reach statistical significance , but a decrease varying from 0.72 to 2.78 kg ( 1 to 8.7 % ) was observed in 13 ( 72 % ) patients . Bone mineral density ( BMD ) increased at lumbar spine , total femur and femoral neck ( P < 0.05 ) . Levels of total and low-density lipoprotein (LDL)-cholesterol were lower after therapy ( P < 0.05 ) , and their changes were directly associated with values at baseline . Insulin levels increased and the insulin resistance index worsened at 12 months ( P < 0.05 ) . Median IGF-I s.d . score was -4.30 ( range , -11.03 to -0.11 ) at baseline and -1.73 ( range , -9.80 to 2.26 ) at 12 months . Normal age-adjusted IGF-I levels were obtained with therapy in 5 of 11 patients who had low IGF-I levels at baseline . Changes in IGF-I levels were not correlated with any biological end point , except changes in LBM ( r = 0.53 , P = 0.02 ) . Side effects were mild and disappeared spontaneously . CONCLUSIONS One-year of a fixed low-dose GH regimen in GHD adults result ed in a significant reduction in body fat , total cholesterol and LDL-cholesterol , and a significant increase in LBM and BMD at lumbar spine and femur , regardless of normalization of IGF-I levels . This regimen led to an elevation of insulin levels and a worsening of the insulin resistance index
Emerging cardiovascular risk factors/markers such as proinflammatory cytokines , C-reactive protein , and adipokines are also increased in GHD patients .
Increased cardiovascular morbidity and mortality have also been reported in GHD .
GH treatment has been shown to improve both traditional and emerging cardiovascular risk factors and markers .
The GHD population may be considered at high cardiovascular risk , and GH substitution may be expected to bring an added value to patients with hypopituitarism in terms of cardiovascular protection .
CONTEXT GH deficiency ( GHD ) of the adult is a clinical condition characterized by the presence of several traditional and emerging cardiovascular risk factors that can significantly increase cardiovascular morbidity and mortality .
It is still an open issue whether GH replacement is able not only to improve cardiovascular risk factors but also to decrease cardiovascular morbidity and mortality .
EVIDENCE SYNTHESIS In untreated GHD , cardiovascular risk is increased due to abnormal lipid profile ( increased total and low-density lipoprotein cholesterol , increased triglycerides , and reduced high-density lipoprotein cholesterol ) and impaired glucose metabolism .