Effects of adult growth hormone deficiency and replacement therapy on the cardiometabolic risk profile

Pituitary. 2022 Apr;25(2):211-228. doi: 10.1007/s11102-022-01207-1. Epub 2022 Feb 1.

Abstract

Adult growth hormone deficiency (AGHD) is considered a rare endocrine disorder involving patients with childhood-onset and adult-onset growth hormone deficiency (AoGHD) and characterized by adverse cardiometabolic risk profile. Besides traditional cardiovascular risk factors, endothelial dysfunction, low-grade inflammation, impaired adipokine profile, oxidative stress and hypovitaminosis D may also contribute to the development of premature atherosclerosis and higher cardiovascular risk in patients with AGHD. Growth hormone replacement has been proved to exert beneficial effects on several cardiovascular risk factors, but it is also apparent that hormone substitution in itself does not eliminate all cardiometabolic abnormalities associated with the disease. Novel biomarkers and diagnostic techniques discussed in this review may help to evaluate individual cardiovascular risk and identify patients with adverse cardiometabolic risk profile. In the absence of disease-specific guidelines detailing how to assess the cardiovascular status of these patients, we generally recommend close follow-up of the cardiovascular status as well as low threshold for a more detailed evaluation.

Keywords: Cardiometabolic risk; Growth hormone deficiency; Growth hormone replacement therapy; Premature atherosclerosis.

Publication types

  • Review

MeSH terms

  • Adult
  • Atherosclerosis*
  • Child
  • Dwarfism, Pituitary*
  • Growth Hormone
  • Hormone Replacement Therapy
  • Human Growth Hormone* / therapeutic use
  • Humans

Substances

  • Human Growth Hormone
  • Growth Hormone