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 .
Atherogenic lipoprotein phenotype and low-density lipoprotein size and subclasses in patients with growth hormone deficiency before and after short-term replacement therapy.
OBJECTIVE Patients with growth hormone deficiency ( GHD ) have increased cardiovascular risk and may show elevated triglyceride and reduced high density lipoprotein ( HDL ) cholesterol concentrations , two lipid abnormalities usually accompanied by increased small dense LDL in the ' atherogenic lipoprotein phenotype ' ( ALP ) . In the present study , we directly investigated ( 1 ) whether hypopituitary patients with GHD have increased small dense LDL ; ( 2 ) whether growth hormone replacement therapy ( GHRT ) beneficially impact on such particles ; ( 3 ) the prevalence of ALP in GHD and GHRT patients . DESIGN AND METHODS In 14 hypopituitary patients with GHD ( 44 + /- 13 years , body mass index ( BMI ) 27 + /- 3 ) before and after 4 months of GHRT , and in 11 healthy age- and BMI -matched controls we measured plasma lipids and LDL size and subclasses by gradient gel electrophoresis . RESULTS Compared with controls , GHD showed increased triglycerides ( P = 0.0024 ) , similar total and LDL cholesterol levels and a tendency towards reduced HDL cholesterol concentrations ( P = 0.0894 ) . GHRT reduced total and LDL cholesterol levels ( P = 0.0303 and 0.0120 respectively ) , but no effect was found on triglycerides and HDL cholesterol levels . LDL size was unchanged in GHD versus controls ( 269 + /- 9 vs 274 + /- 6 A , P = ns ) , but LDL subclass analysis revealed a shift towards more dense particles ( P = 0.0046 ) . GHRT had no significant impact on LDL size and subclasses . The prevalence of ALP was 14 % in GHD and 7 % in GHRT . CONCLUSIONS In GHD patients , individual features of ALP ( including increased small dense LDL ) may be common , but complete ALP is relatively uncommon . Short-term replacement therapy seems to be ineffective on such lipid alterations , but the effect of a longer GHRT remains to be assessed
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 .