Plasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement
UNSPECIFIED. (2003) Plasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement. MOLECULAR GENETICS AND METABOLISM, 80 (3). pp. 330-337. ISSN 1096-7192Full text not available from this repository.
Official URL: http://dx.doi.org/10.1016/ymgme.2003.08.020
Growth hormone (GH) deficiency is associated with increased cardiovascular morbidity and mortality. GH treatment improves the profile of many cardiovascular risk markers in individuals with GH deficiency (GHD). The aim of the present was to assess whether GH replacement may decrease plasma total homocysteine, an independent cardiovascular risk factor, thus potentially contributing to benefits of GH replacement in adult subjects with GHD. Twenty-five patients (17 female, 8 male), mean age 39-years, with GHD were studied. GH status had been determined by an insulin tolerance test and/or arginine stimulation test. After an overnight fast, plasma insulin, IGF-1, total homocysteine (Hcy), free thyroxine (FT4), creatinine, vitamin B12, and folate were measured at baseline (V1), 3 months (V2) and then at 6 months (V3) on GH treatment. The data were analysed by hierarchical statistical models, univariate and multivariate correlation. GH treatment resulted in an increase in IGF-1 (p < 0.001, p < 0.001), and insulin (p = 0.068, p < 0.001), at each visit, respectively. Hcy levels increased from V1 to V2 (7.7 +/- 0.53 to 9.15 +/- 0.45 mumol/L; p = 0.051), but this was followed by a decline at V3 (to 8.8 +/- 0.59), so that the overall change of Hcy levels from V 1 to V3, once individuals had achieved 'adequate' GH replacement, was no longer significantly different (p = 0.090). When separated by gender, at 6 months (V3) there was a small, but significant increase in Hcy in men (p = 0.028), but not in women (p = 0.58). There was no significant change in B12, folate, free T4 or creatinine levels. Univariate analysis revealed that only B12 and folate showed significant negative relationships with Hcy (1112: parameter = -0.013, p < 0.001; folate: parameter=-1.31, p < 0.001), but not between Hcy and IGF-1 (p = 0.18). In a multiple variable model, both B12 and folate remained significantly negatively associated with plasma total homocysteine (p = 0.018; p < 0.001, respectively). In this observational study normalisation of IGF-1 levels in adult subjects with growth hormone deficiency was not associated with a fall in total homocysteine. Before firm conclusions can be drawn about the contribution of changes in plasma homocysteine concentrations to cardiovascular prognosis in adult GHD patients receiving GH replacement, further controlled studies are required. (C) 2003 Elsevier Inc. All rights reserved.
|Item Type:||Journal Article|
|Subjects:||Q Science > QD Chemistry
Q Science > QH Natural history > QH426 Genetics
|Journal or Publication Title:||MOLECULAR GENETICS AND METABOLISM|
|Publisher:||ACADEMIC PRESS INC ELSEVIER SCIENCE|
|Official Date:||November 2003|
|Number of Pages:||8|
|Page Range:||pp. 330-337|
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