Cardiovascular risk factors in adult patients with growth hormone deficiency

Rosén, Thord; Edén, Staffan; Larson, Göran; Wilhelmsen, Lars; Bengtsson, Bengt‐Åke

doi:10.1530/acta.0.1290195

Cited by 321 publications

(188 citation statements)

References 18 publications

(17 reference statements)

Supporting

Mentioning

170

Contrasting

Unclassified

Order By: Relevance

“…34 Hypopituitarism and untreated GHD are linked to a higher incidence of hypertension, 35 but although our patients had a higher blood pressure than the matched control subjects, they were not hypertensive. Given that impairment of baroreflex function has also been found in hypertension, one could argue that hypopituitary patients (and those with other conditions) who develop …”

Section: Burst Amplitude Distribution Is Normal In Other Conditions Wmentioning

confidence: 62%

Sympathetic Neural Burst Amplitude Distribution

et al. 2000

View full text Add to dashboard Cite

Background —Human muscle sympathetic nerve activity (MSNA) is usually measured as the number of pulse-synchronous bursts in multiunit mean voltage recordings. We recently suggested burst amplitude distribution as a more sensitive indicator of altered MSNA in congestive heart failure (CHF). Here, we test whether this distribution can discriminate between different conditions with increased MSNA burst frequency and whether it reflects single vasoconstrictor fiber firing intensity. Methods and Results —We analyzed resting multiunit MSNA in 36 CHF patients (24 with mild to moderate CHF, 12 with severe CHF investigated before and after heart transplantation), 14 patients with pituitary deficiency, 25 matched healthy control subjects, and an additional 56 healthy men with a wider age range (21 to 71 years). Pituitary deficiency was associated with increased MSNA burst frequency (60 versus 37 bursts/min in control subjects), equivalent to that in mild to moderate CHF (61 bursts/min). However, burst amplitude distribution in hypopituitary patients (median burst amplitude, 37%) did not deviate from matched control subjects (36%), whereas amplitudes increased with disease severity in CHF (43% in mild to moderate, 52% in severe) and normalized after transplantation (36%). In the larger healthy group, MSNA burst frequency increased with age, and burst amplitude distribution remained unaffected. In 8 CHF patients, single-unit firing frequency showed a close positive relationship to multiunit burst amplitude distribution ( r =0.82, P <0.01) but none to burst frequency ( r =0.39, P =0.3). Conclusions —Muscle vasoconstrictor fiber activity is better reflected by multiunit MSNA burst amplitude distribution than by burst frequency, at least in CHF. This distribution can discriminate between conditions with increased burst frequency.

show abstract

Section: Burst Amplitude Distribution Is Normal In Other Conditions Wmentioning

confidence: 62%

Sympathetic Neural Burst Amplitude Distribution

et al. 2000

View full text Add to dashboard Cite

show abstract

“…In this study, when investigated as dichotomous variables, only the component of high triglycerides was associated with IGF1 concentrations. (35), but in other studies, only total cholesterol or HDL-cholesterol seems to be abnormal (36). On the other hand, in acromegaly, the same metabolic state is described.…”

Section: Discussionmentioning

confidence: 79%

Serum IGF1, metabolic syndrome, and incident cardiovascular disease in older people: a population-based study

Bunderen

Oosterwerff

Schoor

et al. 2013

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: High as well as low levels of IGF1 have been associated with cardiovascular diseases (CVD). The relationship of IGF1 with (components of) the metabolic syndrome could help to clarify this controversy. The aims of this study were: i) to investigate the association of IGF1 concentration with prevalent (components of) the metabolic syndrome; and ii) to examine the role of (components of) the metabolic syndrome in the relationship between IGF1 and incident CVD during 11 years of follow-up. Methods: Data were used from the Longitudinal Aging Study Amsterdam, a cohort study in a representative sample of the Dutch older population (R65 years). Data were available in 1258 subjects. Metabolic syndrome was determined using the definition of the US National Cholesterol Education Program Adult Treatment Panel III. CVD were ascertained by self-reports and mortality data. Results: Levels of IGF1 in the fourth quintile were associated with prevalent metabolic syndrome compared with the lowest quintile (odds ratio: 1.59, 95% confidence interval (CI) 1.09-2.33). The middle up to the highest quintile of IGF1 was positively associated with high triglycerides in women. Metabolic syndrome was not a mediator in the U-shaped relationship of IGF1 with CVD. Both subjects without the metabolic syndrome and low IGF1 levels (hazard ratio (HR) 1.75, 95% CI 1.12-2.71) and subjects with the metabolic syndrome and high IGF1 levels (HR 2.28, 95% CI 1.21-4.28) demonstrated increased risks of CVD. Conclusions: In older people, high-normal IGF1 levels are associated with prevalent metabolic syndrome and high triglycerides. Furthermore, this study suggests the presence of different pathomechanisms for both low and high IGF1 levels and incident CVD.

show abstract

“…Increased mortality ratio is observed in both CD (1) and hypopituitary patients without GH replacement (21)(22)(23)(24)(25), most often related to cardio-and cerebrovascular risk factors. GH replacement has been shown to improve the adverse body composition, cardiovascular risk factors (25,26), and poor QoL associated with GHD (27,28).…”

Section: Analysis Bmentioning

confidence: 99%

Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

Höybye¹,

Ragnarsson²,

Jönsson³

et al. 2010

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Patients in remission from Cushing's disease (CD) have many clinical features that are difficult to distinguish from those of concomitant GH deficiency (GHD). In this study, we evaluated the features of GHD in a large cohort of controlled CD patients, and assessed the effect of GH treatment. Design and methods: Data were obtained from KIMS, the Pfizer International Metabolic Database. A retrospective cross-sectional comparison of background characteristics in unmatched cohorts of patients with CD (nZ684, 74% women) and nonfunctioning pituitary adenoma (NFPA; nZ2990, 39% women) was conducted. In addition, a longitudinal evaluation of 3 years of GH replacement in a subset of patients with controlled CD (nZ322) and NFPA (nZ748) matched for age and gender was performed. Results: The cross-sectional study showed a significant delay in GHD diagnosis in the CD group, who had a higher prevalence of hypertension, fractures, and diabetes mellitus. In the longitudinal, matched study, the CD group had a better metabolic profile but a poorer quality of life (QoL) at baseline, which was assessed with the disease-specific questionnaire QoL-assessment of GHD in adults. After 3 years of GH treatment (mean dose at 3 years 0.39 mg/day in CD and 0.37 mg/day in NFPA), total and low-density lipoprotein cholesterol decreased, while glucose and HbAlc increased. Improvement in QoL was observed, which was greater in the CD group (K6 CD group versus K5 NFPA group, P!0.01). Conclusion: In untreated GHD, co-morbidities, including impairment of QoL, were more prevalent in controlled CD. Overall, both the groups responded similarly to GH replacement, suggesting that patients with GHD due to CD benefit from GH to the same extent as those with GHD due to NFPA.

show abstract

Cardiovascular risk factors in adult patients with growth hormone deficiency

Cited by 321 publications

References 18 publications

Sympathetic Neural Burst Amplitude Distribution

Sympathetic Neural Burst Amplitude Distribution

Serum IGF1, metabolic syndrome, and incident cardiovascular disease in older people: a population-based study

Clinical features of GH deficiency and effects of 3 years of GH replacement in adults with controlled Cushing's disease

Contact Info

Product

Resources

About