Effect of growth hormone replacement in the vascular system of adult patients with childhood onset hypopituitarism

Abstract

ObjectiveTo evaluate the human recombinant growth hormone replacement (hrGHr) in the metabolic parameters and vascular system in adult patients with childhood onset hypopituitarism (COH).Patients and methodsFifty-one adult with COH were selected for the study. They were divided into 2 groups: 1- hrGHr: 13 male, 14 female with median age 33.2 yrs, rhGHr in adult life with 7.38 yrs median time; 2 - Without hrGHr: 13 male, 11 female with 36.9 yrs median age and without hrGHr in adult life of 10.4 yrs median time. Anthropometric parameters, dual-energy X-ray absorptiometry (DEXA), lipid and glycemic profile, and structural and functional parameters of the arterial vessels (carotid intima media thickness, arterial stiffness and flow mediated dilation) were evaluated.ResultsThe diagnosis of obesity and overweight was higher in patients without hrGHr. Among the anthropometric characteristics, the waist-to-height ratio and diastolic blood pressure were higher in patients without replacement (p = 0.03 and p = 0.019, respectively). In the evaluation of body composition through DEXA, the Fat Mass Index among patients under hrGHr was significantly lower than in patients without hrGHr (p = 0.029). Although no statistical difference in the vascular parameters between patients with and without hrGHr, it was observed a trend towards a higher arterial stiffness in the group without replacement (p = 0.051). In the group of patients without hrGHr, arterial stiffness had a significant and positive correlation with the time without hrGHr (p = 0.038).ConclusionsThese data suggest that the hrGHr in adults with COH may have protective effects on cardiovascular system.