Growth Hormone and Cardiovascular Risk Factors

Gola, M; Bonadonna, Stefania; Doga, Mauro; Giustina, Andrea

doi:10.1210/jc.2004-0545

Cited by 120 publications

(56 citation statements)

References 75 publications

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“…high triglycerides, low HDL cholesterol, elevated small dense LDL) may be common (14-50%), but complete ALP is relatively uncommon (14% in GHD and 7% after GHRT). Therefore, it remains to be established whether quantitative and qualitative changes of lipids are the main cause for the increased cardiovascular mortality and morbidity found in hypopituitary patients with GHD (39,40). Similarly, the lack of effect of GHRT on LDL size in the present study does not support the concept that a possible effect of GHRT on cardiovascular mortality, as recently suggested (41), is related to the effect of GH on lipid metabolism.…”

Section: Ghd Versus Controls (Pz)contrasting

confidence: 83%

Atherogenic lipoprotein phenotype and low-density lipoprotein size and subclasses in patients with growth hormone deficiency before and after short-term replacement therapy

Rizzo

Trepp²,

Berneis³

et al. 2007

eur j endocrinol

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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 (44G13 years, body mass index (BMI) 27G3) 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 (PZ0.0024), similar total and LDL cholesterol levels and a tendency towards reduced HDL cholesterol concentrations (PZ0.0894). GHRT reduced total and LDL cholesterol levels (PZ0.0303 and 0.0120 respectively), but no effect was found on triglycerides and HDL cholesterol levels. LDL size was unchanged in GHD versus controls (269G9 vs 274G6 Å , PZns), but LDL subclass analysis revealed a shift towards more dense particles (PZ0.0046). 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.

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Section: Ghd Versus Controls (Pz)contrasting

confidence: 83%

Atherogenic lipoprotein phenotype and low-density lipoprotein size and subclasses in patients with growth hormone deficiency before and after short-term replacement therapy

Rizzo

Trepp²,

Berneis³

et al. 2007

eur j endocrinol

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“…In active acromegaly, and thus a state of high IGF-I concentrations, cardiac dysfunction with ventricular hypertrophy, hypertension, and type 2 diabetes can be found along with other complications (23). GH deficiency is associated with atherosclerosis, diastolic dysfunction, decreased left ventricular mass, type 2 diabetes, or dyslipidemia for example (24).…”

Section: Introductionmentioning

confidence: 99%

Associations of age-dependent IGF-I SDS with cardiovascular diseases and risk conditions: cross-sectional study in 6773 primary care patients

Schneider¹,

Klotsche²,

Saller³

et al. 2008

European Journal of Endocrinology

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Objective: We aimed at investigating the association of age-dependent IGF-I SDS with diabetes, dyslipidemia, hypertension, and heart diseases, in a large patient sample. Background: IGF-I has been suggested to be associated with several diseases and a prognostic marker for the development of cardiovascular diseases and risk factors. The findings, though, have been inconsistent possibly due to the methodological factors. Methods: We studied 6773 consecutive primary care patients, aged 18C years, in a cross-sectional, epidemiological study in primary care, Diabetes Cardiovascular Risk-Evaluation: Targets and Essential Data for Commitment of Treatment study. All patients underwent a standardized clinical diagnostic and laboratory assessment. IGF-I levels were measured with an automated chemiluminescence assay system. We calculated the odds ratios (OR) for diseases in quintiles of IGF-I, and additionally analyzed the association of age-dependent IGF-I SDS with these conditions. Results: After multiple adjustments for confounders, we found increased ORs for coronary artery disease in patients with high IGF-I. Women, but not men, with low IGF-I also showed increased ORs for coronary artery disease. Dyslipidemia was positively associated with IGF-I. Type 2 diabetes showed a curvilinear association with IGF-I SDS. Conclusions: The findings suggest the existence of multiple and complex interactions between IGF-I and several health conditions. The complex nature of disease-and subgroup-specific associations along with the methodological factors can be held responsible for divergent findings in previous studies. European Journal of Endocrinology 158 153-161

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“…The authors explained this finding by assuming a bone protective effect of estrogens in pre-menopausal women included in this study. Alternatively, an increased bone tissue sensitivity to GH stimulation in males may be hypothesized as already demonstrated for other clinical end-points of GH (38). However, this effect appeared to be independent of the polymorphisms of GHR.…”

Section: European Journal Of Endocrinologymentioning

confidence: 69%

GH receptor isoforms and skeletal fragility in acromegaly

Mormando¹,

Nasto²,

Bianchi³

et al. 2014

European Journal of Endocrinology

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Objective: Acromegaly is associated with an increased prevalence of vertebral fractures (VFs) in close relationship with GH hypersecretion. Two isoforms of the GH receptor (GHR) have been identified; the two isoforms differ or not by the expression of the protein fragment encoded by exon 3 of the GHR gene. Deletion of the exon 3 may influence the functional properties of the GHR and affect fracture risk in acromegalic patients. Design: A cross-sectional study was designed to investigate the association between the d3-GHR isoform and the prevalence of VFs in patients with acromegaly. Methods: In this study, 109 acromegalic patients were included (M/F, 48/61): 73 with controlled/cured acromegaly and 36 with active disease. GHR genotype was assessed in each patient. All patients were evaluated for VFs and bone mineral density at lumbar spine and hip. Serum IGF1 levels and bone metabolism markers were measured. A multivariate analysis was performed to establish risk factors for VFs in our population. Results: d3-GHR carriers showed an increased prevalence of VFs when compared with patients expressing full-length GHR (35/55 vs 12/54; P!0.001). The association between GHR deletion and VFs was demonstrated both in patients with active disease and in those with controlled/cured disease. Out of 35 patients who were prospectively evaluated, 13 (37.1%) developed incident VFs. The incidence of VFs was significantly higher in patients for whom the GHR gene has been deleted when compared with those harboring the fl gene (PZ0.04). In multivariate analysis, male sex (odds ratio (OR), 3.250; PZ0.041), IGF1 levels (OR, 1.183; PZ0.031), length of active diseases (OR, 1.038; PZ0.001), and d3-GHR genotype (OR, 3.060; PZ0.015) were all confirmed as risk factors of VFs in our population. Conclusions: This study suggests for the first time that exon 3 deletion of GHR may predispose patients with active and controlled acromegaly to a higher risk of VFs.

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Growth Hormone and Cardiovascular Risk Factors

Cited by 120 publications

References 75 publications

Atherogenic lipoprotein phenotype and low-density lipoprotein size and subclasses in patients with growth hormone deficiency before and after short-term replacement therapy

Atherogenic lipoprotein phenotype and low-density lipoprotein size and subclasses in patients with growth hormone deficiency before and after short-term replacement therapy

Associations of age-dependent IGF-I SDS with cardiovascular diseases and risk conditions: cross-sectional study in 6773 primary care patients

GH receptor isoforms and skeletal fragility in acromegaly

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