Vasculometabolic effects in patients with congenital growth hormone deficiency with and without GH replacement therapy d
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Vasculometabolic effects in patients with congenital growth hormone deficiency with and without GH replacement therapy during adulthood Isabela Peixoto Biscotto1 · Valéria Aparecida Costa Hong2 · Rafael Loch Batista1 · Berenice Bilharinho Mendonca1 · Ivo Jorge Prado Arnhold1 · Luiz Aparecido Bortolotto2 · Luciani Renata Silveira Carvalho1 Accepted: 17 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluated the metabolic profiles and vascular properties in congenital growth hormone (GH) deficiency (GHD) and its replacement in adults. Patients and methods Cross-sectional study conducted in a single tertiary center for pituitary diseases. Eighty-one adult subjects were divided into three groups: (1) 29 GHD patients with daily subcutaneous GH replacement therapy (GHRT) during adulthood; (2) 20 GHD patients without GHRT during adulthood and (3) 32 controls. Only patients with adequate adherence to others pituitary hormone deficiencies were included. Anthropometric parameters, body composition by dualenergy X-ray absorptiometry, metabolic profiles and vascular properties (carotid intima media thickness, pulse wave velocity and flow-mediated dilation) were compared among the groups. Results Waist-to-height ratio (WHR), body fat percentages and fat mass index (FMI) were lower in patients with GHRT than patients without GHRT during adulthood (0.49 ± 0.06 vs. 0.53 ± 0.06 p = 0.026, 30 ± 10 vs. 40 ± 11 p = 0.003 and 7.3 ± 4 vs. 10 ± 3.5 p = 0.041, respectively). In addition, association between longer GHRT and lower body fat percentage was observed (r = − 0.326, p = 0.04). We found higher triglyceride (113.5 ± 62 vs. 78 ± 36, p = 0.025) and lower HDL cholesterol (51 ± 17 vs. 66 ± 23, p = 0.029) levels in patients without GHRT during adulthood in comparison to controls. No statistical differences were observed for vascular properties among the groups. Conclusions No differences in vascular properties were observed in congenital GHD adult patients with or without GHRT despite patients without GHRT had an unfavorable body composition. GHRT currently remains an individualized decision in adults with GHD and these findings bring new insight into the treatment and follow-up of these patients. Keywords Congenital growth hormone deficiency · Growth hormone replacement therapy · Vascular system · Cardiovascular risk
* Isabela Peixoto Biscotto [email protected]
Luiz Aparecido Bortolotto [email protected]
* Luciani Renata Silveira Carvalho [email protected]
1
Unidade de Endocrinologia do Desenvolvimento, Laboratório de Hormônios e Genética Molecular LIM42, Disciplina de Endocrinologia, Departamento de Clínica Médica do Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, Sao Paulo, SP 05403‑000, Brazil
2
Unidade de Hipertensão, Instituto do Coração, Hospital das Clínicas da Faculdade de Medicina da Universidade São Paulo, Sao Paulo, Brazil
Valéria Aparecida Costa Hong hong.va
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