Abnormal carotid arterial wall dynamics in symptom-free hypopituitary adults

Markussis, V.; Beshyah, Salem A.; Fisher, Charles; Parker, Kim H.; Nicolaides, Andrew; Johnston, Desmond G.

doi:10.1530/eje.0.1360157

Cited by 58 publications

(23 citation statements)

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“…Increased IMT, intimal plaque formation, and reduced arterial compliance were reported previously in Table 3 Baseline characteristics of hypopituitary patients and controls carrying 'a' allele (genotypes a/a and a/b) and bb genotype. hypopituitary adults (31)(32)(33). In our study, older age, higher BMI, and presence of hypopituitarism significantly predicted higher IMT measurements in a logistic regression model.…”

Section: Discussionsupporting

confidence: 45%

Endothelial nitric oxide synthase intron 4a/b polymorphism and early atherosclerotic changes in hypopituitary GH-deficient adult patients

Şen

Demirtürk²,

Abacı³

et al. 2008

European Journal of Endocrinology

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Objective: Endothelial nitric oxide synthase (eNOS) intron 4a/b polymorphism is associated with plasma NO concentrations and coronary artery disease/hypertension in various populations. GH deficiency in adulthood predisposes to reduced NO concentrations and premature atherosclerosis. Our aim was to determine whether intron 4a/b polymorphism of eNOS gene influences endothelial function and early atherosclerotic changes in GH-deficient hypopituitary patients. Design: Thirty-three hypopituitary GH-deficient patients on conventional replacement therapy other than GH and 43 age-, sex-, and body mass index (BMI)-matched controls were studied in this crosssectional case-control study. Methods: Early atherosclerotic changes were determined by flow-mediated dilation (FMD) of brachial artery and carotid artery intima-media thickness (IMT). eNOS4a/b polymorphism was detected by PCR. Results: Hypopituitary patients had significantly higher total/low-density lipoprotein cholesterol and fat mass and lower IGF-I concentrations compared with controls. IMT was significantly higher in patients (0.777G0.23 vs 0.639G0.17 mm, P!0.01). No significant difference was observed with respect to FMD measurements. eNOS4a/b genotype frequencies were similar between patients and controls. Patients carrying 'a' allele (a/a and a/b) had significantly higher IMT compared with controls carrying 'a' allele and bb genotype (P!0.05). However, logistic regression analysis revealed that presence of hypopituitarism, ageR45 years, and BMIR27.9 kg/m 2 were significant independent predictors of IMTR0.65 mm. Conclusion: No compelling data are evident to suggest that eNOS4a/b polymorphism modifies the atherosclerotic process in GH-deficient situations. A large case-control study is needed to confirm our findings.European Journal of Endocrinology 158 615-622

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Section: Discussionsupporting

confidence: 45%

Endothelial nitric oxide synthase intron 4a/b polymorphism and early atherosclerotic changes in hypopituitary GH-deficient adult patients

Şen

Demirtürk²,

Abacı³

et al. 2008

European Journal of Endocrinology

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“…Other atheromatosis markers in GHD are represented by the increased intima media thickness and by a greater carotid and aortic stiffness [70].…”

Section: A Atherosclerosismentioning

confidence: 99%

Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]

et al. 2015

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Abstract. Adult growth hormone deficiency (GHD) is a well defined clinical condition, which is characterized by abnormal body composition, impaired physical activity and decreased quality of life. In addition, in recent years, growing interest has been shown towards cardiovascular risks in adult patients affected by GHD. In this regard, GHD is widely known to be associated with increased mortality, likely due to the increase of risk factors, such as central obesity, impaired lipid and glucose profiles and other less-known risk factors, such as inflammatory cytokines, endothelial dysfunction and oxidative stress. However, very few papers have recently discussed this topic. In this review, the aim is to clarify this issue by discussing evidence regarding the effects of adult GHD on metabolic and cardiovascular profiles.

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“…Premature atherosclerosis of the peripheral arteries and aorta was evident in symptom-free hypopituitary adults [6, 7]. Carotid artery ultrasonography demonstrated increased intima-media thickness (IMT), intimal plaque formation and reduced arterial compliance in hypopituitary adults [6,7,8]. Thickening of the intima and tunica media of the arteries is now considered a marker of initial asymptomatic atherosclerosis.…”

Section: Introductionmentioning

confidence: 99%

Mitral and Tricuspid Annular Velocities Determined by Doppler Tissue Imaging in Hypopituitary, Growth Hormone-Deficient Patients

Yurci

Oflaz²,

Meriç³

et al. 2005

Horm Res Paediatr

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Background: The aim of this study is to determine systolic and diastolic velocity profiles of the left and right ventricles by tissue Doppler imaging (TDI) and to reveal the associations between TDI parameters and early atherosclerotic changes in adult hypopituitary patients with GH deficiency. Patients and Methods: The study group is composed of 16 hypopituitary, GH-deficient patients and 13 healthy controls. All patients had been receiving adequate substitution therapy other than GH at stable doses for at least 6 months. Conventional Doppler echocardiography and TDI of the mitral and tricuspid annulus were performed. Intima-media thickness (IMT) of the common carotid artery was calculated. Results: IMT was significantly higher in the hypopituitary group compared with controls (0.83 ± 0.25 vs. 0.51 ± 0.14 mm, p < 0.001). Hypopituitary patients had significantly lower peak early diastolic (E_m) mitral annular velocity (11.2 ± 3.0 vs. 13.9 ± 2.8 cm/s, p < 0.05). Multiple regression analysis revealed that age was the only independent variable significantly associated with E_m and IMT in the patients. Conclusion: Diastolic abnormalities on TDI of the mitral annulus and early atherosclerotic changes occur concurrently in asymptomatic hypopituitary patients with GH deficiency. Aging may have a more deleterious effect on ventricular function and atherogenesis in this group of patients.

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Abnormal carotid arterial wall dynamics in symptom-free hypopituitary adults

Abstract: Asymptomatic hypopituitary adults (especially women) on conventional replacement therapy have increased stiffness of the common carotid arteries. These findings provide additional evidence for a process leading to premature atherosclerosis in this group of patients.

Cited by 58 publications

References 0 publications

Endothelial nitric oxide synthase intron 4a/b polymorphism and early atherosclerotic changes in hypopituitary GH-deficient adult patients

Endothelial nitric oxide synthase intron 4a/b polymorphism and early atherosclerotic changes in hypopituitary GH-deficient adult patients

Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]

Mitral and Tricuspid Annular Velocities Determined by Doppler Tissue Imaging in Hypopituitary, Growth Hormone-Deficient Patients

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