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One-year GH replacement therapy reduces early cardiac target organ damage (TOD) in adult GHD patients

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Abstract

Hypopituitarism reduces life expectancy and increases the risk of cardiovascular and cerebrovascular diseases, as well as death. Abnormalities in the cardiovascular system may be independently related to GH deficiency (GHD). The aim of this study was to prospectively investigate coronary flow reserve and diastolic function in GHD adult patients at diagnosis and after 1 year of GH replacement therapy. As control group, an age- and sex-matched population was chosen. All patients and controls were non-smokers, non-diabetic, and normotensive, with no history of vascular disease. 14 patients with adult-onset GHD and 17 controls represent the two study groups. Anthropometric data, blood pressure, lipid profile, glycosylated hemoglobin (HbA1c) and IGF-I plasma levels, coronary flow reserve (CFR), and LV diastolic function (evaluated by E/A) were collected in all subjects before and after 12 months of GH replacement therapy. Compared with controls, systolic and diastolic blood pressure and LDL cholesterol levels were significantly higher at baseline and return, comparable to controls after 1 year of GH replacement (GHRT). GHD patients showed a blunted CFR at baseline (P < 0.001) and a significant improvement after GHRT, returning to values comparable with those recorded in the control group. In addition, after therapy a significant (P < 0.001) improvement in E/A was recorded. One year of GH therapy improves CFR and E/A in the patient population analyzed, thereby encouraging the early start of GHRT.

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Acknowledgments

This study was partially supported by Grants from MIUR (2002067251-001), the University of Genova, and from Fondo per gli Investimenti della Ricerca di Base (FIRB RBAU019TMF_001). This paper is dedicated to the memory of Francesco Minuto, who passed away in February 2014.

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Authors and Affiliations

  1. Endocrinology Unit (DiMI), Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Viale Benedetto XV, 6, 16132, Genoa, Italy

    Mara Boschetti, Valeria Albanese, Claudia Teti, Manuela Albertelli & Diego Ferone

  2. Cardiology Unit, Department of Internal Medicine & Medical Specialties, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy

    Sergio Agosti, Laura Casalino, Gian Paolo Bezante & Claudio Brunelli

  3. Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy

    Mara Boschetti, Manuela Albertelli & Diego Ferone

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  1. Mara Boschetti
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  2. Sergio Agosti
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  3. Valeria Albanese
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  4. Laura Casalino
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  9. Diego Ferone
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Correspondence to Mara Boschetti.

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Boschetti, M., Agosti, S., Albanese, V. et al. One-year GH replacement therapy reduces early cardiac target organ damage (TOD) in adult GHD patients. Endocrine 55, 573–581 (2017). https://doi.org/10.1007/s12020-016-0951-4

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