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 .
Adiponectin as predictor for diabetes among pre-diabetic groups
Adiponectin is found to associate with diabetes in studies apart from cohort studies . This prospect i ve cohort study is to evaluate the predictive role of adiponectin in diabetes among participants with impaired fasting glucose ( IFG ) . A total of 42,845 participants who visited 7 health examination centers located in Seoul and Kyunggi province , South Korea , during 2004–2008 were first included . Of the 42,845 participants , 5,085 participants had IFG . IFG was categorized as stage 1 ( fasting glucose 100–109 mg/dL ) or stage 2 ( 110–125 mg/dL ) . The incidence rates of diabetes were followed up to December , 2011 . Hazard ratios ( HRs ) and 95 % confidence intervals ( CI ) were performed by Cox proportional hazard model . Of the 5,085 participants , 652 participants developed  diabetes during a mean follow-up of 4.4 years . Low adiponectin was associated with diabetes among men with stage 2 IFG ( HR , 1.78 ; 95 % CI , 1.33–2.38 ) while it was associated with diabetes among women with stage 1 IFG ( HR , 2.64 ; 95 % CI , 1.38–5.03 ) and stage 2 IFG ( HR , 2.17 ; 95 % CI , 1.07–4.42 ) . When combined men and women , the association between adiponectin and diabetes was statistically significant in stage 2 IFG with an increase of about 82 % ( HR , 1.82 ; 95 % CI , 1.40–2.39 ) after adjusting for age , sex , body mass index , waist circumference , and fasting serum glucose . There was an interaction by sex and stage 1 IFG in the association between adiponectin and risk of diabetes ( P < 0.001 ) . Adiponectin was independently associated with diabetes among participants with IFG . This association was apparent in stage 2 IFG . Adiponectin may be used as a predictor of diabetes in patients having IFG
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 .