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The prevalence of the metabolic syndrome is increased in patients with GH deficiency, irrespective of long-term substitution with recombinant human GH

Department of Endocrinology and Metabolism, Leiden University Medical Centre, Leiden, The Netherlands, ¹ Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands and ² National Institute for Public Health and the Environment, Centre for Nutrition and Health, Bilthoven, The Netherlands

(Correspondence should be addressed to A A van der Klaauw; Email: a.a.van_der_klaauw{at}lumc.nl)

Objectives: Many reports demonstrate improvements in cardiovascular risk factors during GH replacement (rhGH) in adult GH deficiency (GHD). However, it remains to be determined to what extent these changes translate into a reduction of increased cardiovascular morbidity and mortality. The aim of this study was to evaluate the effects of long-term rhGH replacement on the prevalence of the metabolic syndrome (MS).

Design, settings, main outcome measures: The MS was scored by the National Cholesterol Education Program-Adult Treatment Panel III definition in 50 consecutive GHD patients (45 ± 9 years of age), before and after 2 and 5 years of rhGH replacement, and the data of untreated patients were compared with the general population using data from a Dutch population-based study (n = 1062, 44 ± 8 years of age).

Results: Hypertriglyceridaemia (46.0 vs 18.5%, P < 0.0001), hypertension (66.0 vs 35.5%, P < 0.0001) and abdominal obesity (38.0 vs 23.4%, P = 0.0178) were more prevalent in untreated patients when compared with controls, resulting in a higher prevalence of the MS in patients (38.0 vs 15.7%, P < 0.0001). During rhGH replacement at a mean dose of 0.5 ± 0.2 mg/day resulting in IGF-I concentrations in the normal age-adjusted reference range, mean high-density lipoprotein cholesterol level increased compared with baseline (P < 0.001). However, the prevalence of (components of) the MS did not change after 2 or 5 years of treatment with rhGH.

Conclusion: In this study, the prevalence of the MS in patients with GHD is increased compared with healthy controls, irrespective of rhGH replacement.

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