X-Message-Number: 12373
Date: Mon, 6 Sep 1999 01:15:11 -0700 (PDT)
From: Doug Skrecky <>
Subject: growth hormone replacement prevents atherosclerosis

might be worth mentioning again...

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Citations: 1-2
  Borson-Chazot F.  Serusclat A.  Kalfallah Y.  Ducottet X.  Sassolas G. 
  Bernard S.  Labrousse F.  Pastene J.  Sassolas A.  Roux Y.  Berthezene F.
  Service d'Endocrinologie, Hopital de l'Antiquaille, Lyon, France.
  Decrease in carotid intima-media thickness after one year
  growth hormone (GH) treatment in adults
  with GH deficiency.
  Journal of Clinical Endocrinology & Metabolism.  84(4):1329-33, 1999 Apr.
  An increased carotid arterial intima-media thickness (IMT) has been reported
  in hypopituitary adults untreated for GH deficiency. In the present study,
  the effect of GH replacement on IMT and cardiovascular risk factors was
  prospectively investigated, in GH deficiency patients treated at a mean dose
  of 1 UI/day during 1 yr (n = 22) and 2 yr (n = 11). The IMT measurements were
  performed by the same experienced physician, and the coefficient of variation
  (calculated in two control groups) was below 6.5%. IMT at baseline was
  related to conventional risk factors. After 1 yr GH treatment, IMT decreased
  from 0.78 +/- 0.03 mm to 0.70 +/- 0.03 mm (P < 0.001). The decrement was
  observed in 21 of 22 patients. After 2 yr GH treatment, IMT had stabilized at
  0.70 +/- 0.04 mm and remained significantly different from baseline values (P
  < 0.003). GH treatment resulted in a moderate decrease in waist circumference
  and body fat mass and an increase in VO2 max. Conventional cardiovascular
  risk factors were unmodified except for a transient 10% decrease in
  low-density lipoprotein cholesterol at 6 months. The contrast between the
  limited metabolic effect of treatment and the importance and precocity of the
  changes in IMT suggests that the decrease in IMT was not exclusively
  attributable to a reversal in the atherosclerotic process. A direct parietal
  effect of GH replacement on the arterial wall might also be involved. The
  consequences, in terms of cardiovascular risk, should be established by
  randomized prospective trials.

  Pfeifer M.  Verhovec R.  Zizek B.  Prezelj J.  Poredos P.  Clayton RN.
  Department of Endocrinology, Diabetes and Metabolic Diseases, University
  Medical Center, Ljubljana, Slovenia.
  Growth hormone (GH) treatment reverses
  early atherosclerotic changes in GH-deficient adults.
  Journal of Clinical Endocrinology & Metabolism.  84(2):453-7, 1999 Feb.
  Hypopituitary patients have increased mortality from vascular disease, and in
  these patients, early markers of atherosclerosis [increased carotid artery
  intima-media thickness (IMT) and reduced distensibility] are more prevalent.
  As GH replacement can reverse some risk factors of atherosclerosis, the
  present study examined the effect of GH treatment on morphological and
  functional changes in the carotid and brachial arteries of GH-deficient (GHD)
  adults. Eleven GHD hypopituitary men (24-49 yr old) were treated with
  recombinant human GH (0.018 U/kg BW x day) for 18 months. IMT of the common
  carotid artery (CCA) and the carotid bifurcation (CB), and flow-mediated
  endothelium-dependent dilation (EDD) of the brachial artery were measured by
  B mode ultrasound before and at 3, 6, 12, and 18 months of treatment, and
  values were compared with those in 12 age-matched control men. Serum
  concentrations of lipids, lipoprotein(a), insulin-like
  growth factor I (IGF-I), and IGF-binding protein-3 (IGFBP-3)
  were also measured. In GHD men before treatment the IMTs of the CCA
  [mean(SD), 0.67(0.05) mm] and CB [0.75(0.04) mm] were significantly greater
  (P < 0.001) than those in control men [0.52(0.07) and 0.65(0.07) mm,
  respectively]. GH treatment normalized the IMT of the CCA by 6 months
  [0.53(0.04) mm] and that of the CB by 3 months [0.68(0.05) mm]. The IMT of
  the carotid artery (CCA and CB) was negatively correlated with serum IGF-I (r
  = -0.53; P < 0.0001). There was a significant improvement in flow-mediated
  EDD of the brachial artery at 3 months, which was sustained at 6 and 18
  months of GH treatment (P < 0.05). GH treatment increased high density
  lipoprotein cholesterol at 3 and 6 months, but did not reduce total or low
  density lipoprotein cholesterol and was without effect on lipoprotein(a).
  There was no correlation between plasma lipids and changes in IMT or EDD of
  the arteries examined. In conclusion, GH treatment of hypopituitary GHD men
  reverses early morphological and functional atherosclerotic changes in major
  arteries and, if maintained, may reduce vascular morbidity and mortality. GH
  seems to act via IGF-I, which is known to have important effects on
  endothelial cell function.

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