(Circulation. 2001;103:520.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Abnormal Vascular Reactivity in Growth Hormone Deficiency
From the Departments of Internal Medicine and Cardiovascular Sciences and of Endocrinology, University Federico II, Naples, Italy.
Correspondence to Luigi Saccà, MD, Medicina Interna, via Pansini 5, 80131 Napoli, Italy. E-mail sacca{at}unina.it
Background—The reason why patients with growth hormone (GH) deficiency (GHD) are at increased risk for premature cardiovascular death is still unclear. Although a variety of vascular risk factors have been identified in GHD, little is known regarding vascular reactivity and its contribution to premature arteriosclerosis.
Methods and Results—We assessed vascular function in 7 childhood-onset, GH-deficient nontreated patients (age 22±3 years, body mass index [BMI] 25±1 kg/m2) and 10 healthy subjects (age 24±0.4 years, BMI 22±1 kg/m2) by using strain gauge plethysmography to measure forearm blood flow in response to vasodilatory agents. The increase in forearm blood flow to intrabrachial infusion of the endothelium-dependent vasodilator acetylcholine was significantly lower in GH-deficient nontreated patients than in control subjects (P<0.05). Likewise, forearm release of nitrite and cGMP during acetylcholine stimulation was reduced in GH-deficient nontreated patients (P<0.05 and P<0.002 versus controls). The response to the endothelium-independent vasodilator sodium nitroprusside was also markedly blunted in GH-deficient patients compared with control subjects (P<0.005). To confirm that abnormal vascular reactivity was due to GHD, we also studied 8 patients with childhood-onset GHD (age 31±2 years, BMI 24±1 kg/m2) who were receiving stable GH replacement therapy. In these patients, the response to both endothelium-dependent and -independent vasodilators, as well as forearm nitrite and cGMP, release was not different from that observed in normal subjects. Peak hyperemic response to 5-minute forearm ischemia was significantly reduced in GH-deficient nontreated patients (17.2±2.6 mL · dL-1 · min-1, P<0.01) but not in GH-treated patients (24.8±3.3 mL · dL-1 · min-1) compared with normal subjects (29.5±3.2 mL · dL-1 · min-1).
Conclusions—The data support the concept that GH plays an important role in the maintenance of a normal vascular function in humans.
Key Words: growth factors • hormones • vascular dysfunction • arteriosclerosis • nitric oxide
This article has been cited by other articles:
 |
|
 |
|
  G. Li, J.-P. del Rincon, L. A. Jahn, Y. Wu, B. Gaylinn, M. O. Thorner, and Z. Liu Growth Hormone Exerts Acute Vascular Effects Independent of Systemic or Muscle Insulin-like Growth Factor I J. Clin. Endocrinol. Metab., April 1, 2008; 93(4): 1379 - 1385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Thum, F. Fleissner, I. Klink, D. Tsikas, M. Jakob, J. Bauersachs, and D. O. Stichtenoth Growth Hormone Treatment Improves Markers of Systemic Nitric Oxide Bioavailability via Insulin-Like Growth Factor-I J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4172 - 4179. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Tivesten, A. Barlind, K. Caidahl, N. Klintland, A. Cittadini, C. Ohlsson, and J. Isgaard Growth hormone-induced blood pressure decrease is associated with increased mRNA levels of the vascular smooth muscle KATP channel J. Endocrinol., October 1, 2004; 183(1): 195 - 202. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Napoli, V. Guardasole, V. Angelini, F. D'Amico, E. Zarra, M. Matarazzo, and L. Sacca Acute Effects of Growth Hormone on Vascular Function in Human Subjects J. Clin. Endocrinol. Metab., June 1, 2003; 88(6): 2817 - 2820. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Piatti, G. Fragasso, L. D. Monti, E. Setola, P. Lucotti, I. Fermo, R. Paroni, E. Galluccio, G. Pozza, S. Chierchia, et al. Acute Intravenous l-Arginine Infusion Decreases Endothelin-1 Levels and Improves Endothelial Function in Patients With Angina Pectoris and Normal Coronary Arteriograms: Correlation With Asymmetric Dimethylarginine Levels Circulation, January 28, 2003; 107(3): 429 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Tivesten, E. Bollano, I. Andersson, S. Fitzgerald, K. Caidahl, K. Sjogren, O. Skott, J.-L. Liu, R. Mobini, O. G. P. Isaksson, et al. Liver-Derived Insulin-Like Growth Factor-I Is Involved in the Regulation of Blood Pressure in Mice Endocrinology, November 1, 2002; 143(11): 4235 - 4242. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Brevetti, P. Marzullo, A. Silvestro, R. Pivonello, G. Oliva, C. di Somma, G. Lombardi, and A. Colao Early Vascular Alterations in Acromegaly J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3174 - 3179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. F. Attanasio, P. C. Bates, K. K. Y. Ho, S. M. Webb, R. J. Ross, C. J. Strasburger, R. Bouillon, B. Crowe, K. Selander, D. Valle, et al. Human Growth Hormone Replacement in Adult Hypopituitary Patients: Long-Term Effects on Body Composition and Lipid Status--3-Year Results from the HypoCCS Database J. Clin. Endocrinol. Metab., April 1, 2002; 87(4): 1600 - 1606. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Napoli, V. Guardasole, M. Matarazzo, E. A. Palmieri, U. Oliviero, S. Fazio, and L. Sacca Growth hormone corrects vascular dysfunction in patients with chronic heart failure J. Am. Coll. Cardiol., January 2, 2002; 39(1): 90 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Napoli, B. Biondi, V. Guardasole, M. Matarazzo, F. Pardo, V. Angelini, S. Fazio, and L. Sacca Impact of Hyperthyroidism and Its Correction on Vascular Reactivity in Humans Circulation, December 18, 2001; 104(25): 3076 - 3080. [Abstract] [Full Text] [PDF]
|
|