Biochemical and Biophysical Markers of Endothelial Dysfunction in Adults with Hypopituitarism and Severe GH Deficiency

• DOI: 10.1210/jcem.86.9.7813
• Publication Date: 2014-01-08T12:07:29Z
• Authors: T. A. Elhadd; T. A. Abdu; J. Oxtoby; G. Kennedy; M. McLaren; R. Neary; J. J. F. Belch; R. N. Clayton
• Keywords: Endothelial Dysfunction; Brachial artery; Thrombomodulin; Interquartile range

Adult hypopituitarism is known to be associated with reduced life expectancy related excess vascular events, and endothelial dysfunction present in patients this condition. We studied the relationship between biophysical biochemical markers of dysfunction, including E-selectin, intercellular cell adhesion molecule-1, von Willebrand factor, thrombomodulin 52 adult severe GH deficiency (<2 ng/ml on provocative testing) compared 54 age-, sex-, smoking-matched normal controls. also examined endothelium-dependent dilatation brachial artery postischemic occlusion carotid morphology (intima-media thickness) by high-resolution ultrasonography. The were stable conventional hormone replacement therapy but not therapy, none subjects had a risk factor for disease. Levels E-selectin [57 ± 3 vs. 49 2 (mean sem)] (P < 0.043), molecule-1 (308 11 266 10 ng/ml) 0.001), (49 35 (132 7% 105 5%) 0.004) significantly higher than Brachial was lower controls [4.7% (0.00–9.77) 10.5% (6.4–16.2) (median, interquartile range)] 0.001). This difference more marked female 0.003), although it disappeared when estrogen-sufficient = 0.31). However, who replaced estrogen continued show striking estrogen-deficient control females 0.004). There no intima-media thickness either sex On univariate analysis, correlated inversely (r −0.225, P 0.033). Intercellular positively 0.466, 0.0001) negatively IGF-I −0.238, 0.016). 0.215, P< 0.034) 0.218, 0.03) =− 0.255, 009). Thrombomodulin 0.422, 0.266, 0.008). These correlations persisted after correction age, sex, body mass index, waist hip ratio, exception IGF-I, which now only. results confirm significant provide insight into early atherosclerosis hypopituitary GH-deficient adults. negative correlation some predictive nature stepwise regression analysis study supports hypothesis that may play role these abnormalities. Future studies will determine whether treatment can reverse Furthermore, abnormality those replete suggests crucial element protecting against