Cardiovascular risk factors in growth hormone deficiency: is vitamin D a new kid on the block?

摘要: It is now close to 30 years since two pioneering studies on GH treatment of adult patients with deficiency (GHD) were published [1, 2]. Both groups reported beneficial effects cardiac function and body composition. Since then cardiovascular function, morbidity, risk factors have remained in focus numerous publications the field. Some classical that are associated GHD adults include insulin resistance, unfavourable shifts serum lipid pattern including increased low density lipoprotein (LDL)-cholesterol concentration, impaired fibrinolysis, sympathetic nervous activity (for review see [3]). More recently homocysteine C-reactive protein [4]) pregnancy plasma protein-A (PAPP-A) which has been observed be elevated [5]. Furthermore, PAPP-A considered both a factor modulator IGF-I bioavailability In addition, composition often deteriorates hypopituitary fat decreased cell mass. During last years, vitamin D emerged as potentially important general, although cut-off levels for definition normal remain controversial. Its role explored by Savanelli et al. [6]. Although some evidence exists suggest reciprocal regulation GH/IGF-I system D, this first study systematically evaluate status compared controls. Interestingly, study, had significantly lower than controls also higher frequency insufficiency. Low quite strongly dyslipidaemia, hypertension, metabolic syndrome but not diabetes mellitus. many limitations, comparatively small population previous radiotherapy possibly receiving optimal replacement therapy other hormones, it none less interesting warrants further topic. Results obviously need confirmed larger populations challenged if they endpoints such morbidity mortality. will linked per se improved substitution and/or supplementation optimise positive therapy. normalises most Body rapidly normalised appear at least partly sustained after 15 Unfavourable changes concentrations fibrinolysis A modest improvement nerve was found 1 year replacement. The sensitivity still controversial, one 7-year provided protection from age related decline sensitivity. Whether & Jorgen Isgaard jorgen.isgaard@medic.gu.se