SUN-577 Effect of Growth Hormone Replacement on Metabolic Profile and Vascular System in Adult Patients with Congenital Hypopituitarism

Abstract

Introduction: Growth Hormone (GH) stimulates two distinct processes: anabolic effect of GH on growth through IGF1, and catabolic effect of GH stimulating lipolysis. GH deficiency (GHD) in adulthood is characterized with abnormal body composition, impairment of physical capacity and lipid and glycemic metabolism, beyond increase cardiovascular risk (CVR) factors. While in acquired hypopituitarism, GHD is always associated with CVR in several studies and demonstrated human recombinant growth hormone replacement (hrGHr) improves CVR. In congenital hypopituitarism (CH), however, the consequences of GHD and hrGHr in adulthood are unclear. Objective: To evaluate daily hrGHr in metabolic profile and vascular system in adult patients with CH. Patients and Methods: Fifty-nine adults with CH were selected for the study. They were divided into 2 groups: 1- hrGHr: 15 male, 17 female with median age 35,8 yrs, hrGHr in adult life with 7.2 yrs median time in the dose of approximately 1U per day in order to keep IGF1 in the normal range for age and sex; 2- Without hrGHr: 12 male, 15 female with 38,4 yrs median age and without hrGHr in adult life of 10.6 yrs median time. Thirty-two healthy volunteers were selected as controls. Anthropometric parameters, dual-energy X-ray absorptiometry (DXA), 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 and compared between the groups. Results: In patients with rhGHr the abdominal waist/height (AW/H) ratio (0,49 ± 0,06), the fat percentage (30,7 ± 10,4) and fat index (7,6 ± 3,7) were lower than the group without replacement (p= <0,001, p= <0,001 and p= 0,028, respectively). The low values of the CA/H ratio, fat percentage and fat index were independent of the diagnosis ACTH deficiency with corticosteroid replacement. Higher triglycerides (111,7 ± 62,4) and lower HDLc (49,5 ± 19,1) levels in patients without hrGHr compared to controls (p= 0,020 and p= 0,005, respectively) were observed. There was no statistical difference between glycemic profile, metabolic comorbidities and structural and function parameters of the arterial vessels between groups and controls. Conclusions: GHD in CH does not lead to accelerated premature atherosclerosis and arteriosclerosis. The hrGHr in adults with CH have beneficial effects on lipid profile and body composition and hrGHr in adulthood should be individualized.