Arterial stiffness in hypopituitary patients with life-long growth hormone deficiency

Abstract

Patients with hypopituitarism have a shorter survival period from and premature mortality due to cardiovascular complications. The aim of our study was to evaluate the arterial stiffness and hemodynamic parameters based on pulse wave analysis in 22 adult patients with long-life growth hormone (GH) and insulin-like factor I (IGF-I) deficiencies, lasting from 22 to 57 years. In all patients, a combined pituitary hormone deficiency was diagnosed. All patients were on substitution therapy, receiving levothyroxine, sex hormones and hydrocortisone (when required), but none of the patients had ever received recombinant GH therapy. A control group consisted of 36 healthy subjects strictly matched to patients by age and body mass index. In the patients and control subjects pulse wave analysis was performed with the use of Sphigmocor MX reconstructing the aortic pulse wave in a real time. The peripheral and central augmentation indexes were significantly increased in the hypopituitary patients compared with the control subjects. The central pulse pressure was also elevated in the patients. These hemodynamic parameters pointed to an increased arterial stiffness. In patients with hypopituitarism, the life-long GH and IGF-I deficiencies lead to an increase in the arterial stiffness.