Key result
Growth hormone supplementation in adult patients with GH deficiency showed a nonsignificant reduction in overall cardiovascular risk (weighted mean 0.53, 95% CI -1.23 to 2.85), though it significantly reduced LDL cholesterol and fat mass.
Why the study?
Does GH replacement therapy reduce cardiovascular risk in adult patients with GH deficiency?
Systematic Review and Meta-Analysis (n=952)
Does GH replacement therapy reduce cardiovascular risk in adult patients with GH deficiency?
GH replacement therapy in adult GHD patients improves body composition and LDL cholesterol but does not significantly reduce overall calculated cardiovascular risk.
BACKGROUND AND OBJECTIVE: The current meta-analysis aims at evaluating whether the existing clinical evidence may ascertain the effects of growth hormone (GH) replacement therapy on cardiovascular risk, both in isolated GH deficiency (GHD) and in compensated panhypopituitarism including GH deficit. METHODS: Original articles published from 1991 to 2015 were searched on Medline (Pubmed). Among an overall number of 181 potentially suitable studies, 24 fulfilled the selection criteria and were included in the analysis. Data aggregation was carried out through the calculation of the absolute risk reduction. The meta-analysis was then conducted by means of a fixed-effects model, according to the heterogeneity test (Chi-square statistic). RESULTS: Fat-free mass (FFM) increase and fat mass (FM) reduction were found, together with a C-LDL reduction, a wide variation in glycaemia and a neutral effect on glycated haemoglobin (HbA1c) and blood pressure. These effects were valid both for isolated GHD patients and for those with compensated panhypopituitarism. The global outcome D showed a nonsignificant reduction of the overall cardiovascular risk (0.53; 95% C.I. -1.23, 2.85). CONCLUSION: Our meta-analysis shows no signnificatly positive trend in cardiovascular risk after both short and long-term GH supplementation therapy in adult GHD patients. However, a reduction of LDL cholesterol levels has been found. No differences were found between isolated GHD participants and those affected by panhypopituitarism well compensated since at least 3 months.
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Giagulli et al. (2017) conducted a systematic review and meta-analysis in Growth hormone deficiency (GHD) (n=952). Growth hormone (GH) supplementation vs. Placebo or baseline (unexposed) was evaluated on Overall cardiovascular risk (global outcome D) (Weighted mean 0.53, 95% CI -1.23 to 2.85, p=nonsignificant). Growth hormone supplementation in adult patients with GH deficiency showed a nonsignificant reduction in overall cardiovascular risk (weighted mean 0.53, 95% CI -1.23 to 2.85), though it significantly reduced LDL cholesterol and fat mass.
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