EARLY ATHEROSCLEROTIC CHANGES IN HIPOPITUITARY PATIENTS WITH GROWTH HORMONE DEFICIENCY
Objective: Cardiovascular diseases have been implicated in excess mortality in adult hypopituitary patients (HP) who do not receive growth hormone (GH) replacement. GH deficiency induces a proatherogenic state. In this study we aimed to investigate endothelial function and early atherosclerotic changes in GH-deficient HP. Material and methods: Endothelial function was assessed by flow mediated dilation (FMD) of the brachial artery. Demographic, anthropometric, endocrine and biochemical findings, brachial artery FMD and carotid artery intima-media thickness (IMT) were recorded.
Results: Nineteen HP not receiving GH (9 women, age: 42±16 years) and 19 healthy controls (6 women, age: 39±16 years) were enrolled. In HP, the waist circumference (94.5±13.2 cm vs. 86.8±8.7 cm, p=0.04), and the body fat mass (%) were found higher(30.9±9.1 vs. 23.8±8.6, p=0.02), the lean body mass (%) was found lower (69.0±9.1 vs. 76.1±8.6, p=0.01). The carotid artery IMT was higher (0.80±0.22 vs. 0.56±0.25, p=0.01) and the brachial artery FMD was lower (8.8±6.06 vs. 13.5±4.6, p=0.02) in HP compared to healthy controls. There was a significant correlation between patient age and carotid artery IMT in both groups; the association was more prominent in the patient group (r=0.8624 p<0.001 for patients, r=0.7859 p=0.001 for controls).
Conclusion: The decreased FMD in the GH-deficient HP established the endothelial dysfunction. The relationship between carotid artery IMT and age was more prominent in the hypopituitary group. Our findings suggest that endothelial function is impaired in HP and the effects of aging on atherosclerosis appear in a more pronounced way in HP.
Key words: Hipopituitarism, growth hormone deficiency, endothelial function