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BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞiKLİKLER

EARLY ATHEROSCLEROTIC CHANGES IN HIPOPITUITARY PATIENTS WITH GROWTH HORMONE DEFICIENCY

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2011

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Abstract (2. Language): 
Objective: Cardiovascular diseases have been implicated in excess mortality in adult hypopituitary patients (HP) who do not receive growth hormone (GH) replacement. GH deficiency induces a proatherogenic state. In this study we aimed to investigate endothelial function and early atherosclerotic changes in GH-deficient HP. Material and methods: Endothelial function was assessed by flow mediated dilation (FMD) of the brachial artery. Demographic, anthropometric, endocrine and biochemical findings, brachial artery FMD and carotid artery intima-media thickness (IMT) were recorded. Results: Nineteen HP not receiving GH (9 women, age: 42±16 years) and 19 healthy controls (6 women, age: 39±16 years) were enrolled. In HP, the waist circumference (94.5±13.2 cm vs. 86.8±8.7 cm, p=0.04), and the body fat mass (%) were found higher(30.99.1 vs. 23.88.6, p=0.02), the lean body mass (%) was found lower (69.09.1 vs. 76.18.6, p=0.01). The carotid artery IMT was higher (0.80±0.22 vs. 0.56±0.25, p=0.01) and the brachial artery FMD was lower (8.8±6.06 vs. 13.5±4.6, p=0.02) in HP compared to healthy controls. There was a significant correlation between patient age and carotid artery IMT in both groups; the association was more prominent in the patient group (r=0.8624 p<0.001 for patients, r=0.7859 p=0.001 for controls). Conclusion: The decreased FMD in the GH-deficient HP established the endothelial dysfunction. The relationship between carotid artery IMT and age was more prominent in the hypopituitary group. Our findings suggest that endothelial function is impaired in HP and the effects of aging on atherosclerosis appear in a more pronounced way in HP.
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Abstract (Original Language): 
Amaç: Kalp ve damar hastalıklarının büyüme hormonu (BH) replasmanı almayan eriĢkin hipopitüiter (HP) hastalarda mortaliteye ek katkıda bulunduğu bildirilmektedir. BH eksikliği proaterojenik bir duruma neden olmaktadır. Bu çalıĢmada BH eksikliği olan HP hastalarda endotel fonksiyonu ve erken aterosklerotik değiĢiklikleri incelemeyi amaçladık. Gereç ve yöntem: Endotel fonksiyonu brakiyal arterin akıma bağlı dilatasyonu (FMD) ile değerlendirildi. Demografik, antropometrik, endokrin ve biyokimyasal bulgular ile brakiyal arter FMD ve karotis intima-media kalınlığı (ĠMK) ölçümleri kaydedildi. Bulgular: ÇalıĢmaya 19 BH almayan HP hasta (9 kadın, 42±16 yaĢ) ile 19 sağlıklı kontrol (6 kadın, 39±16 yaĢ) alındı. HP hastalarda kontrollere göre kalça çevresi (94,5±13,2 cm vs. 86,8±8,7 cm, p=0,04), vücut yağ kütlesi (%) daha yüksek bulundu (30,99,1 vs. 23,88,6, p=0,02). HP hastalarda yağsız vücut kütlesi (%) daha düĢüktü (69,09,1 vs. 76,18,6, p=0,01). Karotis ĠMK‟sı hastalarda kontrollere oranla daha yüksek (0,80±0,22 vs. 0,56±0,25, p=0,01), brakiyal arter FMD‟si ise daha düĢüktü (8,8±6,06 vs. 13,5±4,6, p=0,02). Her iki gruptada hasta yaĢı ile karotis ĠMK‟sı arasında anlamlı bir korelasyon mevcuttu ancak iliĢki hasta grubunda daha belirgindi (hastalar için r=0,8624 p<0,001, kontroller için r=0,7859 p=0,001). Sonuç: BH eksikliği olan HP hastalardaki düĢük FMD endotel disfonksiyonunu ortaya koymuĢtur. Hipopitüiter grupta karotis ĠMK‟sı ile yaĢ arasındaki iliĢki daha belirgindi. Bulgularımız HP hastalarda endotel fonksiyonunun bozulduğuna ve yaĢlanmanın ateroskleroz üzerine etkilerinin daha belirgin hal aldığına iĢaret etmektedir.
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İstanbul Tıp Fakültesi Dergisi Cilt / Volume: 74 • Sayı / Number: 1 • Yıl/Year:

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