A 24‐Hour Comparison of Serum Growth Hormone Concentrations in Patients with Heart Failure versus Healthy Controls

Duncan, Brett; Moyna, Niall M.; Heller, Gary V.; McGill, Carol C.; Katten, Deborah; Finta, Laurie; Velusamy, M; Kelsey, Anita M.; Wieczorek, Stacey J.; Wu, Alan H.B.; White, C. Michael

doi:10.1592/phco.23.2.147.32093

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…The positive correlation between acylated ghrelin and GH or IGF-1 among our rEF patients may also support the validity of the clinical trials that used ghrelin (37,42,43) or GH (9,13,14,44) for treatment of their patients, and observed improvement in the patients' condition, such as increasing exercising capacity, left ventricular function and reduces proinflamatory cytokins. On the other hand, while our data for ghrelin (45), GH (32,44), and IGF-1 (46) are consistent with earlier reports, there are reports that showed circulating ghrelin (47,48) and GH (27,49) increase in patients with cardiac cachexia and observed deterioration of their patients' health. The discrepancy in the results have prompted experts in the field to stress the need for evaluating the basal endocrine status of the patients before treating them with GH, and for paying particular attention to those patients who present with a peripheral GH resistance (5).…”

Section: Discussionsupporting

confidence: 93%

Circadian rhythm of acylated ghrelin, leptin, growth hormone, IGF-1, IGFBP-1 and IGFBP-3

Moshtaghi-Kashanian¹,

Mirzaee

khalilzadeh

2011

Int J Endocrinol Metab

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Disturbance of anabolic hormones such as ghrelin and leptin could be the cause of developing cardiovascular diseases. In addition, imbalance between ghrelin/GH/IGF-1 axis and leptin may be the reason for reduction of ejection fraction among cardiovascular patients. Background: Following detection of receptors for ghrelin and growth hormone (GH) in the cardiovascular system, different clinical trials have used ghrelin or GH for the treatment of cardiac patients. While some of these trials reported improvements in the patients' situation, others reported deterioration. Objectives: To clarify the contradictory outcomes, we designed this study to evaluate the circadian rhythms of acylated ghrelin, GH, and the related factors [Insulin-like Growth Factor-1 (IGF-1), Insulin-like Growth Factor Binding Proteins 1 and 3 (IGFBP-1 and IGFBP-3)], and leptin in patients with reduced ejection fraction (rEF). Patients and Methods: Ten patients with rEF and an equal number of healthy control subjects matched for age and gender participated in this study according to inclusion criteria. All participants were hospitalized in the cardiac care unit (CCU), under identical conditions during collection of blood (every 2 hours). Primary processing of samples was carried out immediately and the plasma was stored at-20ºC until evaluation of the aforementioned parameters using ELISA methods. Results: Evaluation of the collected data showed that among aged participants only circulating leptin is gender-dependent, while the patients had significantly (P < 0.001) lower ghrelin, GH, IGF-1, and IGFBP-1, but a higher level of IGFBP-3 compared to the control group. In addition, except for GH that showed a mild circadian rhythm, the parameters we examined did not have a significant circadian rhythm. Correlation analysis of the data showed a positive correlation between ghrelin and GH or IGF-1, and significant negative or positive correlations between leptin and IGFBP-1, or IGFBP-3, respectively, in both groups. Conclusions: Here, for the first time, we show that circulating ghrelin, GH, and IGF-1 levels are reduced in the patients with rEF, and the condition of patients is deteriorated not only due to reduced IGF-1 but also due to reduction of IGFBP-1 or increase of IGFBP-3, which may be influenced by circulating leptin. Finally, disturbance of the balance between ghrelin/GH/IGF-1 and leptin may be the cause of rEF, and thus evaluation of these parameters could provide diagnostic as well as prognostic tools for the treatment of these patients.

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Section: Discussionsupporting

confidence: 93%

Circadian rhythm of acylated ghrelin, leptin, growth hormone, IGF-1, IGFBP-1 and IGFBP-3

Moshtaghi-Kashanian¹,

Mirzaee

khalilzadeh

2011

Int J Endocrinol Metab

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“…Only cachectic CHF patients with advanced disease seem to have a high prevalence of GH resistance and IGF-1 deficiency [8]. Intermittent or higher doses of GH could be more effective in GH resistance and or suppressed GH concentration [21,22], reducing catabolism, apoptosis, and increasing anabolism [23]. In experimental heart failure higher doses of GH but not low doses reduced apoptosis, muscle atrophy, and serum levels of TNF-alpha [24].…”

Section: Discussionmentioning

confidence: 99%

Beneficial effects of high doses of growth hormone in the introduction and optimization of medical treatment in decompensated congestive heart failure

Bocchi¹,

Moura²,

Guimarães³

et al. 2006

International Journal of Cardiology

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“…34 Many of the somatotrophic effects of GH are mediated through the production of IGF-I. In contrast to what has been reported in humans with DCM, 17,19,21 the plasma IGF-I concentration in the dogs with DCM was not significantly different from that in the control dogs. Reduced plasma IGF-I concentration in humans with DCM may be a consequence of the impaired nutritional status that is frequently seen in end-stage DCM.…”

Section: Discussionmentioning

confidence: 81%

“…The activity of this axis has been reported to be decreased in human patients with DCM, especially when the severity of cardiac dysfunction is taken into account. [15][16][17][18][19][20] Moreover, prolonged GH deficiency may contribute to the development of human DCM. 12 There is, however, controversy about the beneficial effects of GH treatment in these patients.…”

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confidence: 99%

Evaluation of pulsatile plasma concentrations of growth hormone in healthy dogs and dogs with dilated cardiomyopathy

Beijerink

Lee²,

Stokhof³

et al. 2011

ajvr

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A 24‐Hour Comparison of Serum Growth Hormone Concentrations in Patients with Heart Failure versus Healthy Controls

Abstract: Growth hormone concentrations are suppressed over a 24-hour period in patients with CHF versus healthy controls. Variability in levels throughout the day suggests that a single point evaluation cannot be used to determine deficiency or abundance of growth hormone.

Cited by 7 publications

References 18 publications

Circadian rhythm of acylated ghrelin, leptin, growth hormone, IGF-1, IGFBP-1 and IGFBP-3

Circadian rhythm of acylated ghrelin, leptin, growth hormone, IGF-1, IGFBP-1 and IGFBP-3

Beneficial effects of high doses of growth hormone in the introduction and optimization of medical treatment in decompensated congestive heart failure

Evaluation of pulsatile plasma concentrations of growth hormone in healthy dogs and dogs with dilated cardiomyopathy

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