Authors: A I Pincelli R Bragato M Scacchi G Branzi G Osculati R Viarengo G Leonetti Francesco Cavagnini
Publish Date: 2014/03/18
Volume: 26, Issue: 5, Pages: 420-428
Abstract
GH replacement therapy given 3 times weekly TWI and adjusted to allow serum IGFI concentrations in the midnormal range for sex and age has been shown to be as effective as the daily regimen in improving lipid profile body composition bone mass and turnover in adult GH deficient GHD patients Only one study has investigated so far the shortterm 6 months effect of a fixed weightbased TWI dosing schedule on heart structure and function in childhood onset CO GHD patients whereas such a schedule in adult onset AO GHD patients has not been studied as yet Aim of this study was to investigate whether a 1yr lowdose titrated TWI GHreplacement regimen aimed at achieving and maintaining IGFI levels within the low normal limits for age and sex is able to affect cardiovascular and heart parameters in a group of AO GHD patients Eight adult patients 4 women and 4 men age 358±337 yr body mass index BMI 287±262 kg/m2 with AO GHD were included in the study along with 10 healthy subjects matched for age sex BMI and physical activity 6 women and 4 men age 352±405 yr BMI 284±234 kg/m2 M and B mode ecocardiography and pulsed doppler examination of transmitral flow were performed in GHD patients at baseline and after 3 and 12 months of GH therapy mean GH dose 67±08 μg/kg/day given thrice a week while normal subjects were studied once Treatment with GH for 1 yr induced a significant increase in left ventricular LV diastolic and systolic volumes +111 and +165 respectively Systolic LV posterior wall thickness and LV mass were increased +102 and +77 respectively by GH administration Systemic vascular resistance was significantly decreased by 1yr GH therapy −138 after 1 yr while stroke volume cardiac output and cardiac index were increased +94 +116 and +119 respectively LV endsystolic stress was decreased at the end of GH therapy −112 E and A wave significantly reduced at baseline were increased by 1 yr of GH therapy +233 and +281 respectively likewise the abnormally high E peak deceleration time was partially reversed by GH administration −107 Our study though conducted in a small sample size demonstrates that a TWI GH treatment schedule is able to reverse the cardiovascular abnormalities in AO GHD patients and to improve body composition and lipid profile The maintenance of circulating IGFI concentrations within the low normal range allows to avoid most of the sideeffects reported with higher GH doses while being costeffective and improving the patient’s compliance
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