Congenital Growth Hormone (GH) Deficiency and Atherosclerosis: Effects of GH Replacement in GH-Naive Adults

Oliveira, Joselina Luzia Menezes; Aguiar‐Oliveira, Manuel H.; Júnior, Argemiro D’Oliveira; Pereira, Rossana M. C.; Oliveira, Carla R. P.; Farias, Catarine T.; Barreto‐Filho, José Augusto; Anjos-Andrade, Fernando D; Marques-Santos, Celi; Nascimento-Junior, Adão C.; Alves, Erica O; Oliveira, Francielle T; Campos, Viviane C.; Ximenes, Roberto; Blackford, Amanda L.; Parmigiani, Giovanni; Salvatori, Roberto

doi:10.1210/jc.2007-1636

Cited by 59 publications

(53 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We noted an increase in IMT, and in the number of individuals with atherosclerotic plaques (from only one at baseline to five after GH and to fourteen 12 months after completion of therapy), together with an increase in left ventricular mass index, posterior wall, and septum thickness, and a late increase in SBP that persisted at the 12-month washout (12).…”

Section: Introductionmentioning

confidence: 80%

“…The beneficial effects on body composition and metabolic profile were also demonstrated in children and adolescents together with a good somatic growth response (15). Despite these positive effects, GHRT in IGHD adults caused a progressive increase in IMT, SBP, and in the number of individuals with atherosclerotic carotid plaques (from one to 14) up to 12 months after GHRT completion (12). Now we show that SBP and IMT reduced from 12 to 60mo, both returning to the baseline values, despite 5 and 1/2 years of aging, and despite cholesterol levels at 60mo being no different from 12mo.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, our data were generated in middle-aged adults with genetic IGHD at a dose of depot GH only used once previously in adults (13). This may have resulted in a relatively high daily dose per body weight, although this is unlikely, as serum nadir IGF1 never actually normalized throughout the study (12). The depot form may have exposed tissues to constant levels of GH, resembling a mild form of acromegaly.…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of carotid IMT Longitudinal ultrasonography scans of the carotid arteries were performed by the same trained observer as described previously (12). Atherosclerotic plaque was defined as a localized thickening R1.3 mm, which did not uniformly involve the whole carotid with or without flow disturbance (12).…”

Section: Study Protocolmentioning

confidence: 99%

“…Atherosclerotic plaque was defined as a localized thickening R1.3 mm, which did not uniformly involve the whole carotid with or without flow disturbance (12).…”

Section: Study Protocolmentioning

confidence: 99%

See 4 more Smart Citations

Arrest of atherosclerosis progression after interruption of GH replacement in adults with congenital isolated GH deficiency

Araújo

Aguiar‐Oliveira

Oliveira

et al. 2012

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Objective: GH replacement therapy (GHRT) in adult-onset GH deficiency (AOGHD) reduces carotid intima-media thickness (IMT) and increases myocardial mass, with improvement of systolic and diastolic function. These observations have reinforced the use of GHRT on AOGHD. Conversely, we have previously reported that in adults with lifetime congenital and severe isolated GH deficiency (IGHD) due to a mutation in GHRH receptor gene (GHRHR), a 6-month treatment with depot GH increased carotid IMT, caused the development of atherosclerotic plaques, and an increase in left ventricular mass index (LVMI), posterior wall, and septal thickness and ejection fraction. Such effects persisted 12 months after treatment (12-month washout -12mo). Methods: We have studied the cardiovascular status (by echocardiography and carotid ultrasonography) of these subjects 60 months after completion of therapy (60-month washout -60mo). Results: Carotid IMT reduced significantly from 12 to 60mo, returning to baseline (pre-therapy) value. The number of individuals with plaques was similar at 12 and 60mo, remaining higher than pretherapy. LVMI, relative posterior wall thickness, and septum thickness did not change between 12 and 60mo, but absolute posterior wall increased from 12 to 60mo. Systolic function, evaluated by ejection fraction and shortening fraction, was reduced at 60mo in comparison with 12mo returning to baseline levels. The E/A wave ratio (expression of diastolic function) decreased at 60mo compared with both 12mo and baseline. Conclusions: In adults with lifetime congenital IGHD, the increase in carotid IMT elicited by GHRT was transitory and returned to baseline 5 years after therapy discontinuation. Despite this, the number of subjects with plaques remained stable at 60mo and higher than at baseline. 166 977-982 European Journal of Endocrinology

show abstract

Section: Introductionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

“…Atherosclerotic plaque was defined as a localized thickening R1.3 mm, which did not uniformly involve the whole carotid with or without flow disturbance (12).…”

Section: Study Protocolmentioning

confidence: 99%

See 3 more Smart Citations