Endocrine Abstracts

Adults with hypopituitarism are known to have reduced life expectancy with a 2-fold higher risk of death for cardiovascular disease compared with controls. In Italy, to identify individuals at high risk for cardiovascular disease, the function of the Progetto CUORE has been identified and the global cardiovascular risk score has been built using data from different Italian cohorts. To assess the global cardiovascular risk score in adult hypopituitaric patients: 108 hypopituitaric GHD patients (m:45, f: 47; 35–69 yrs), 62 hypopituitaric non GHD patients (m:21, f: 41; 35–69 yrs) and 108 matched controls were studied. At study entry, all subjects were tested with GHRH+ARG and serum IGF-1, total cholesterol, HDL-cholesterol; systolic blood pressure (SBP), smoking habit, diabetes and hypertension treatment were assessed in all subjects. The score was calculated using a test on the website www.cuore.iss.it. At baseline, the global cardiovascular risk score, total cholesterol and SBP were higher (P<0.001), while HDL cholesterol (P<0.0001) GH peak and IGF-I levels were lower in patients than in controls (P<0.001). In particular, the global cardiovascular risk score and total-cholesterol (P<0.05) were higher, while GH peak and IGF-I levels (P<0.001) were lower in GHD patients than in non GHD patients. No significant difference was found in age, SBP, HDL-cholesterol between two patient groups. An inverse correlation was found between the risk score and GH peak and serum IGF-1 both in patients and in controls. In conclusion, a significant impairment of the global cardiovascular risk score was found in hypopituitaric patients who were replaced for the other pituitary hormones except for GH, indicating a high risk for the development of major coronary or cerebrovascular events in the next ten years. However, whether GH replacement can reduce this risk remains to be established.