Effects of growth hormone (GH) administration on homocyst(e)ine levels in men with GH deficiency : A randomized controlled trial

GH deficiency is associated with increased cardiovascular mortality and early manifestations of atherosclerosis. Elevated serum homocyst(e)ine levels have been found to be associated with increased cardiovascular risk. The effect of GH replacement on homocyst(e)ine has not been investigated to date....

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Veröffentlicht in:The journal of clinical endocrinology and metabolism 2001-04, Vol.86 (4), p.1518-1524
Hauptverfasser: SESMILO, Gemma, BILLER, Beverly M. K, LLEVADOT, Joan, HAYDEN, Douglas, HANSON, Greta, RIFAI, Nader, KLIBANSKI, Anne
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container_end_page 1524
container_issue 4
container_start_page 1518
container_title The journal of clinical endocrinology and metabolism
container_volume 86
creator SESMILO, Gemma
BILLER, Beverly M. K
LLEVADOT, Joan
HAYDEN, Douglas
HANSON, Greta
RIFAI, Nader
KLIBANSKI, Anne
description GH deficiency is associated with increased cardiovascular mortality and early manifestations of atherosclerosis. Elevated serum homocyst(e)ine levels have been found to be associated with increased cardiovascular risk. The effect of GH replacement on homocyst(e)ine has not been investigated to date. We evaluated the effect of GH replacement on fasting homocyst(e)inemia in a group of men with adult-onset GH deficiency in a randomized, single blind, placebo-controlled trial. Forty men with adult-onset GH deficiency were randomized to GH or placebo for 18 months, with dose adjustments made according to serum insulin-like growth factor I (IGF-I) levels. Fasting serum homocyst(e)ine, folate, vitamin B12, and total T(3) levels were determined at baseline and 6 and 18 months. Anthropometry, IGF-I levels, insulin, and glucose were measured at 1, 3, 6, 12, and 18 months. Nutritional assessment, body composition, total T(4), thyroid hormone binding index, and free T(4) index were assessed every 6 months. Homocyst(e)ine decreased in the GH-treated group compared with that in the placebo group (net difference, -1.2 +/- 0.6 micromol/L; confidence interval, -2.4, -0.02 micromol/L; P = 0.047). Homocyst(e)ine at baseline was negatively correlated with plasma levels of folate (r = -0.41; P = 0.0087). Total T(3) increased in the GH-treated group vs. that in the placebo group (net difference, 0.17 +/- 0.046 ng/dL; confidence interval, 0.071, 0.26 nmol/L; P = 0.0012). Folate and vitamin B12 levels did not significantly change between groups. Changes in homocyst(e)ine were negatively correlated with changes in IGF-I. For each 1 nmol/L increase in IGF-I, homocyst(e)ine decreased by 0.04 +/- 0.02 micromol/L (P = 0.029). In contrast, changes in homocyst(e)ine did not correlate with changes in folate, vitamin B12, total T(3), C-reactive protein, interleukin-6, or insulin levels. This study shows that GH replacement decreases fasting homocyst(e)ine levels compared with placebo. This may be one of the mechanisms involved in the putative modulation of atherosclerosis and cardiovascular risk by GH replacement.
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K</creatorcontrib><creatorcontrib>LLEVADOT, Joan</creatorcontrib><creatorcontrib>HAYDEN, Douglas</creatorcontrib><creatorcontrib>HANSON, Greta</creatorcontrib><creatorcontrib>RIFAI, Nader</creatorcontrib><creatorcontrib>KLIBANSKI, Anne</creatorcontrib><title>Effects of growth hormone (GH) administration on homocyst(e)ine levels in men with GH deficiency : A randomized controlled trial</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>GH deficiency is associated with increased cardiovascular mortality and early manifestations of atherosclerosis. Elevated serum homocyst(e)ine levels have been found to be associated with increased cardiovascular risk. The effect of GH replacement on homocyst(e)ine has not been investigated to date. We evaluated the effect of GH replacement on fasting homocyst(e)inemia in a group of men with adult-onset GH deficiency in a randomized, single blind, placebo-controlled trial. 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Folate and vitamin B12 levels did not significantly change between groups. Changes in homocyst(e)ine were negatively correlated with changes in IGF-I. For each 1 nmol/L increase in IGF-I, homocyst(e)ine decreased by 0.04 +/- 0.02 micromol/L (P = 0.029). In contrast, changes in homocyst(e)ine did not correlate with changes in folate, vitamin B12, total T(3), C-reactive protein, interleukin-6, or insulin levels. This study shows that GH replacement decreases fasting homocyst(e)ine levels compared with placebo. This may be one of the mechanisms involved in the putative modulation of atherosclerosis and cardiovascular risk by GH replacement.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Folic Acid - blood</subject><subject>Growth Hormone - deficiency</subject><subject>Growth Hormone - therapeutic use</subject><subject>Homocysteine - blood</subject><subject>Homocystine - blood</subject><subject>Hormones. Endocrine system</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nutrition Assessment</subject><subject>Pharmacology. 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Drug treatments</topic><topic>Single-Blind Method</topic><topic>Thyroid Hormones - blood</topic><topic>Time Factors</topic><topic>Vitamin B 12 - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SESMILO, Gemma</creatorcontrib><creatorcontrib>BILLER, Beverly M. K</creatorcontrib><creatorcontrib>LLEVADOT, Joan</creatorcontrib><creatorcontrib>HAYDEN, Douglas</creatorcontrib><creatorcontrib>HANSON, Greta</creatorcontrib><creatorcontrib>RIFAI, Nader</creatorcontrib><creatorcontrib>KLIBANSKI, Anne</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SESMILO, Gemma</au><au>BILLER, Beverly M. K</au><au>LLEVADOT, Joan</au><au>HAYDEN, Douglas</au><au>HANSON, Greta</au><au>RIFAI, Nader</au><au>KLIBANSKI, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of growth hormone (GH) administration on homocyst(e)ine levels in men with GH deficiency : A randomized controlled trial</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2001-04-01</date><risdate>2001</risdate><volume>86</volume><issue>4</issue><spage>1518</spage><epage>1524</epage><pages>1518-1524</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><coden>JCEMAZ</coden><abstract>GH deficiency is associated with increased cardiovascular mortality and early manifestations of atherosclerosis. Elevated serum homocyst(e)ine levels have been found to be associated with increased cardiovascular risk. The effect of GH replacement on homocyst(e)ine has not been investigated to date. We evaluated the effect of GH replacement on fasting homocyst(e)inemia in a group of men with adult-onset GH deficiency in a randomized, single blind, placebo-controlled trial. Forty men with adult-onset GH deficiency were randomized to GH or placebo for 18 months, with dose adjustments made according to serum insulin-like growth factor I (IGF-I) levels. Fasting serum homocyst(e)ine, folate, vitamin B12, and total T(3) levels were determined at baseline and 6 and 18 months. Anthropometry, IGF-I levels, insulin, and glucose were measured at 1, 3, 6, 12, and 18 months. Nutritional assessment, body composition, total T(4), thyroid hormone binding index, and free T(4) index were assessed every 6 months. Homocyst(e)ine decreased in the GH-treated group compared with that in the placebo group (net difference, -1.2 +/- 0.6 micromol/L; confidence interval, -2.4, -0.02 micromol/L; P = 0.047). Homocyst(e)ine at baseline was negatively correlated with plasma levels of folate (r = -0.41; P = 0.0087). Total T(3) increased in the GH-treated group vs. that in the placebo group (net difference, 0.17 +/- 0.046 ng/dL; confidence interval, 0.071, 0.26 nmol/L; P = 0.0012). Folate and vitamin B12 levels did not significantly change between groups. Changes in homocyst(e)ine were negatively correlated with changes in IGF-I. For each 1 nmol/L increase in IGF-I, homocyst(e)ine decreased by 0.04 +/- 0.02 micromol/L (P = 0.029). In contrast, changes in homocyst(e)ine did not correlate with changes in folate, vitamin B12, total T(3), C-reactive protein, interleukin-6, or insulin levels. This study shows that GH replacement decreases fasting homocyst(e)ine levels compared with placebo. This may be one of the mechanisms involved in the putative modulation of atherosclerosis and cardiovascular risk by GH replacement.</abstract><cop>Bethesda, MD</cop><pub>Endocrine Society</pub><pmid>11297577</pmid><doi>10.1210/jc.86.4.1518</doi><tpages>7</tpages></addata></record>
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source Oxford University Press Journals All Titles (1996-Current); MEDLINE; EZB-FREE-00999 freely available EZB journals
subjects Adult
Biological and medical sciences
Folic Acid - blood
Growth Hormone - deficiency
Growth Hormone - therapeutic use
Homocysteine - blood
Homocystine - blood
Hormones. Endocrine system
Humans
Male
Medical sciences
Middle Aged
Nutrition Assessment
Pharmacology. Drug treatments
Single-Blind Method
Thyroid Hormones - blood
Time Factors
Vitamin B 12 - blood
title Effects of growth hormone (GH) administration on homocyst(e)ine levels in men with GH deficiency : A randomized controlled trial
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