In long-term GHRT-treated AGHD patients, cIMT correlated significantly with body mass index (r=0.584, p=0.001) and visceral adipose tissue area (r=0.791, p<0.001).
What are the determinants of early atherosclerotic changes in adults with growth hormone deficiency receiving long-term replacement therapy?
In adults with growth hormone deficiency on long-term replacement therapy, early atherosclerotic changes are driven by traditional cardiovascular risk factors like visceral adiposity rather than pituitary disease characteristics.
Absolute Event Rate: 0% vs 0%
Background: Patients with adult growth hormone deficiency (AGHD) show accelerated atherosclerosis. While growth hormone replacement therapy (GHRT) may help mitigate this process, the mechanisms driving atherosclerosis progression in GHRT-treated patients with AGHD remain unclear. Methods: Thirty-one patients with AGHD on daily GHRT for ≥5 years were assessed in this crosssectional study. Carotid intima-media thickness (cIMT) was evaluated by ultrasound. Reactive hyperemia index (RHI) was measured using peripheral arterial tonometry. Associations between vascular measures and clinical, pituitary, treatment, body composition, and laboratory parameters were evaluated. Results: cIMT correlated with body mass index (r=0.584, p=0.001) and visceral adipose tissue area (r=0.791, p<0.001), while demonstrating nominally significant associations with triglyceride levels, insulin resistance index, smoking history, and arterial hypertension. Neither the current nor the 5-year mean insulin-like growth factor 1 standard deviation score directly correlated with vascular parameters. Median cIMT was higher in adult-onset compared with child-onset AGHD (0.70 vs. 0.58 mm; p=0.020), while median RHI was lower in genetic than structural etiology (1.58 vs. 2.18; p=0.010); however, both associations were nominally significant. Discussion: Several of the identified cardiovascular risk factors associated with cIMT are unlikely to be sufficiently controlled through GHRT. Pituitary disease characteristics may play a role in atherogenesis; however, the subgroups defined by disease onset timing and etiology were small and not fully comparable. Conclusion: In long-term GHRT-treated patients, cIMT is linked to well-established cardiovascular risk factors rather than features of the pituitary disorder and its management, highlighting the need for targeted cardiovascular risk management alongside GHRT in AGHD.
Klinc et al. (Thu,) reported a other. In long-term GHRT-treated AGHD patients, cIMT correlated significantly with body mass index (r=0.584, p=0.001) and visceral adipose tissue area (r=0.791, p<0.001).
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