Abstract
Introduction: Adult with Childhood onset hypopituitarism (CHO), include growth hormone deficiency is characterized by abnormal body composition, impaired lipid and glycemic metabolism, impairment of physical capacity and increase in cardiovascular risk factors (CVR), besides being associated with the presence of atheromatous plaques in the carotid and femoral arteries, increased mean intimal thickness, and increased arterial stiffness. There is evidence of the role of GH replacement in the atherogenic profile and CVR, however they are limited and controversial. Objective: To evaluate the human recombinant growth hormone replacement (hrGHr) daily in the metabolic parameters and vascular system in adult patients with COH. Patients and Methods: Fifty-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, hrGHr in adult life with 7.38 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: 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. Results: The 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). Conclusions: These data suggest that the hrGHr in adults with COH may have protective effects on cardiovascular system.
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