Background: Severe GH deficiency (GHD) is associated with, increased cardiovascular (CV) risk and intima-media thickness (IMT) at major arteries.
Objective: To investigate the long-term (5-years) effects of GH replacement on insulin resistance (IR) syndrome (IRS) (at least two of: triglycerides levels ≥1.7 mmol/l, HDL-cholesterol levels ≤1.0 mmol/l, blood pressure above 130/85 mmHg, fasting glucose 6.17 or 2 h after glucose 7.711.1 mmol/l), and common carotid IMT.
Design: Interventional, open, prospective, controlled.
Patients: About 35 men with severe GHD aged <50 years (standard replacement therapy plus GH was given to 22 (Group A) and except GH in 13 (Group B)) and 35 healthy men age-matched with the patients as control.
Results: At baseline, 18 patients (51.4%) and two controls (5.7%; P<0.0001) had IRS. The patients with IRS had a longer estimated duration of GHD (P=0.006), lower IGF-I SDS (P=0.002) and higher IMT (P=0.041) than those without IRS. Mean IMT was significantly higher in the patients with (P<0.001) and without IRS (P=0.004) than in controls. During the study period, the use of lipid lowering drugs (92.3%, vs 13.6% and 34.3%, P<0.0001), glucose lowering drugs (69.2% vs 31.4% and 22.7%; P=0.016) and of anti-hypertensive drugs (61.5% vs 20.0% and 4.5%; P<0.0001) was higher in Group B patients than in controls and in Group A patients. After 5 years, IGF-I levels were normal in all Group A patients and remained lower than −1 SDS in 10 of 13 Group B patients. IMT at right and left common carotids significantly decreased only in Group A, while it significantly increased in controls and non significantly in group B patients. The prevalence of IRS significantly reduced only in group A patients, non significantly reduced also in group B patients while slightly increased in controls.
Conclusions: Severely GHD men have more frequently IRS and increased IMT at common carotid arteries than sex- and age-matched controls. Only in GH replaced GHD patients after 5 years was observed decreased IMT and decreased prevalence of IRS.
03 - 07 May 2008
European Society of Endocrinology