Plasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement.

2.50
Hdl Handle:
http://hdl.handle.net/10541/78237
Title:
Plasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement.
Authors:
Lewandowski, Krzysztof C; Murray, Robert D; Drzewoski, J; O'Callaghan, Chris J; Czupryniak, L; Hillhouse, Edward W; Shalet, Stephen M; Randeva, Harpal S
Abstract:
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 micromol/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 V1 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 (B12: 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.
Affiliation:
Molecular Medicine Research Group, Biomedical Research Institute, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
Citation:
Plasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement. 2003, 80 (3):330-7 Mol. Genet. Metab.
Journal:
Molecular Genetics and Metabolism
Issue Date:
Nov-2003
URI:
http://hdl.handle.net/10541/78237
DOI:
10.1016/j.ymgme.2003.08.020
PubMed ID:
14680980
Type:
Article
Language:
en
ISSN:
1096-7192
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorLewandowski, Krzysztof C-
dc.contributor.authorMurray, Robert D-
dc.contributor.authorDrzewoski, J-
dc.contributor.authorO'Callaghan, Chris J-
dc.contributor.authorCzupryniak, L-
dc.contributor.authorHillhouse, Edward W-
dc.contributor.authorShalet, Stephen M-
dc.contributor.authorRandeva, Harpal S-
dc.date.accessioned2009-08-21T14:21:08Z-
dc.date.available2009-08-21T14:21:08Z-
dc.date.issued2003-11-
dc.identifier.citationPlasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement. 2003, 80 (3):330-7 Mol. Genet. Metab.en
dc.identifier.issn1096-7192-
dc.identifier.pmid14680980-
dc.identifier.doi10.1016/j.ymgme.2003.08.020-
dc.identifier.urihttp://hdl.handle.net/10541/78237-
dc.description.abstractGrowth 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 micromol/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 V1 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 (B12: 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.en
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshCreatinine-
dc.subject.meshFemale-
dc.subject.meshFolic Acid-
dc.subject.meshHomocysteine-
dc.subject.meshHormone Replacement Therapy-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshImmunoradiometric Assay-
dc.subject.meshInsulin-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshLinear Models-
dc.subject.meshLongitudinal Studies-
dc.subject.meshMale-
dc.subject.meshThyroxine-
dc.subject.meshVitamin B 12-
dc.titlePlasma total homocysteine concentrations in adults with growth hormone (GH) deficiency: effects of GH replacement.en
dc.typeArticleen
dc.contributor.departmentMolecular Medicine Research Group, Biomedical Research Institute, University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.en
dc.identifier.journalMolecular Genetics and Metabolismen

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