Risk factors of cardiovascular disease in GH-deficient adults with hypopituitarism: a preliminary report.

BACKGROUND: We estimated the influence of GH deficiency (GHD) in adults on chosen risk factors of cardiovascular disease and bone density.

MATERIAL/METHODS: Fifty-four adults (mean age: 50.4 years) with hypopituitarism were studied. We measured blood pressure, body mass index, waist-to-hip ratio, total body fat, and bone mineral density and the serum levels of lipids, glucose, insulin, pituitary hormones, estradiol, testosterone, and thyroxine, and the excretion of free cortisol in 24-h urine. GHD was confirmed with the insulin intravenous test (IIT) with a GH response to IIT of <3 microg/ml. The control group consisted of 73 healthy adults.

RESULTS: Increased levels of LDL-cholesterol and triglycerides and decreased levels of HDL-cholesterol in the GHD group were observed. Fasting serum glucose and insulin levels were significantly higher in the GHD group than in controls. Significant differences in the QUICKI and FIRI indexes were observed. Twenty-three percent of the hypopituitary patients were hypertensive and 65% were obese. The percentage of total body fat was significantly higher in the studied group than in controls. Thirty-seven percent of the GHD patients were osteoporotic and 23% were osteopenic.

CONCLUSIONS: An atherogenic lipid profile, insulin resistance, obesity, and increased body and trunk fat in GHD adults may cause the higher risk of cardiovascular disease in these patients. GHD adults should receive human recombinant GH along with conventional replacement therapy. This may be a useful method in protecting against early onset of atherosclerosis, metabolic disturbances, and osteoporosis, especially in young patients.