Fasting levels of growth hormone are associated with carotid intima media thickness but are not affected by fluvastatin treatment

Erik Hallengren,Andreas Bergmann,Olle Melander,Margaretha Persson,Bo Hedblad,Gerd Östling,Gunnar Engström,Maria Rosvall,Joachim Struck,Peter Almgren

doi:10.1186/s12872-017-0563-9

Abstract

BackgroundGrowth hormone (GH) has been linked to cardiovascular disease but the exact mechanism of this association is still unclear. We here test if the fasting levels of GH are cross-sectionally associated with carotid intima media thickness (IMT) and whether treatment with fluvastatin affects the fasting level of GH.MethodsWe examined the association between GH and IMT in 4425 individuals (aged 46–68 years) included in the baseline examination (1991–1994) of the Malmö Diet and Cancer cardiovascular cohort (MDC-CC). From that cohort we then studied 472 individuals (aged 50-70 years) who also participated (1994–1999) in the β-Blocker Cholesterol-Lowering Asymptomatic Plaque Study (BCAPS), a randomized, double blind, placebo-controlled, single-center clinical trial. Using multivariate linear regression models we related the change in GH-levels at 12 months compared with baseline to treatment with 40 mg fluvastatin once daily.ResultsIn MDC-CC fasting values of GH exhibited a positive cross-sectional relation to the IMT at the carotid bulb independent of traditional cardiovascular risk factors (p = 0.002). In a gender-stratified analysis the correlation were significant for males (p = 0.005), but not for females (p = 0.09). Treatment with fluvastatin was associated with a minor reduction in the fasting levels of hs-GH in males (p = 0.05) and a minor rise in the same levels among females (p = 0.05).ConclusionsWe here demonstrate that higher fasting levels of GH are associated with thicker IMT in the carotid bulb in males. Treatment with fluvastatin for 12 months only had a minor, and probably not clinically relevant, effect on the fasting levels of hs-GH.

Highlights

Growth hormone (GH) has been linked to cardiovascular disease but the exact mechanism of this association is still unclear
GH and statins share some effects on metabolism and we identified these similarities as an opportunity to further explore the previously discovered association between GH and cardiovascular disease (CVD)
In similar multivariate regression models as in the previous paragraph we investigated if ΔGH (12-0 months) was associated with intima media thickness (IMT) outcome at 36 months, to evaluate if change in High sensitivity growth hormone (hs-GH) affected the outcome of medical therapy on the IMT

Summary

Introduction

Growth hormone (GH) has been linked to cardiovascular disease but the exact mechanism of this association is still unclear. We found that an increased fasting level of growth hormone (GH) is an independent predictor of cardiovascular morbidity and mortality [1]. This is somewhat surprising since GH in healthy adults is negatively associated with other predictors of cardiovascular disease (CVD) such as LDL-C, total cholesterol and triglycerides [1, 2]. GH is an anabolic stress hormone and a known These two effects of GH, i.e. decreases LDL-C with negative effects on glucose homeostasis, is seen with statins, which is one of the cornerstones in secondary and primary prevention of cardiovascular disease [10, 11]. In vitro studies suggest that statins may lower GH gene expression [16]

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