Endocrine Abstracts

Introduction: GH deficiency in adulthood is associated with increased cardiovascular risk, which is attributed to unfavorable changes in body composition and in metabolic parameters.

Aim: We evaluated haemodynamic, metabolic, inflammatory and coagulation indices that may contribute to the increased cardiovascular risk in GH deficient subjects.

Methods: Twenty-four patients diagnosed with GH deficiency (13 male), with a mean (S.D.) age of 54.3 (2.7), were compared to 15 healthy age, sex and BMI matched, controls. Anthropometric characteristics (BMI and waist-to-hip ratio (WHR)), blood pressure, basal GH, IGF-I, fasting glucose, fasting insulin, HbA1c, lipid levels, ApoA1, ApoB, hs-CRP, fibrinogen, PAI-1, t-PA and circulating thrombomodulin levels were measured in all study participants. Insulin resistance (IR) was calculated by HOMA and, in ten subjects who had undergone an oral glucose tolerance test, insulin sensitivity was also estimated using Matsuda index.

Results: Patients with GH deficiency exhibited a marginally increased WHR and had significantly higher fasting insulin levels, fasting glucose-to-insulin ratio, HbA1c, total-chol, LDL-chol and triglyceride levels, higher ApoB and lower HDL, compared to controls. IR did not differ by HOMA-IR, however, patients were less insulin sensitive than controls.

Fibrinogen levels and PAI-1 levels did not differ significantly, but t-PA was markedly increased compared to controls. Thrombomodulin levels were not affected.

Conclusions: A considerable number of risk factors including insulin sensitivity, lipid and lipoprotein levels and pro-thrombotic factors are affected in GH deficient adults. Studies addressing whether GH substitution results in decreased CVD morbidity and mortality are needed so therapy could be more vigorously implemented in such patients.