Colao Annamaria, Di Somma Carolina, Savanelli Maria Cristina, De Leo Monica, Lombardi Gaetano
Department of Molecular and Clinical Endocrinology and Oncology, University Federico II of Naples, Via S. Pansini 5, 80123 Naples, Italy.
Growth Horm IGF Res. 2006 Jul;16 Suppl A:S41-8. doi: 10.1016/j.ghir.2006.03.006. Epub 2006 May 11.
Both growth hormone (GH) and insulin-like growth factor I (IGF-I) are involved in heart development and in maintenance of cardiac structure and performance. Cardiovascular disease has been reported to reduce life expectancy in both GH deficiency (GHD) and GH excess. Patients with GHD suffer from a cluster of abnormalities associated with increased cardiovascular risk, including abnormal body composition, unfavorable lipid profile, increased fibrinogen and C-reactive protein levels, insulin resistance, early atherosclerosis and endothelial dysfunction, and impaired left ventricular (LV) performance (i.e., reduced diastolic filling and impaired response to peak exercise). Long-term GH replacement therapy reverses most of these abnormalities. More consistently, GH replacement reduces body fat and visceral adipose tissue, reduces low-density lipoprotein cholesterol and triglyceride levels, and improves endothelial function. GH replacement also reduces intima media thickness at major arteries and improves LV performance, but these results have been observed only in small series of patients treated on a short-term basis. This review discusses the roles of GHD and GH replacement therapy in the development of cardiovascular disease.
生长激素（GH）和胰岛素样生长因子I（IGF-I）均参与心脏发育以及心脏结构和功能的维持。据报道，心血管疾病会降低生长激素缺乏症（GHD）和生长激素过量患者的预期寿命。GHD患者存在一系列与心血管风险增加相关的异常情况，包括身体成分异常、脂质谱不良、纤维蛋白原和C反应蛋白水平升高、胰岛素抵抗、早期动脉粥样硬化和内皮功能障碍，以及左心室（LV）功能受损（即舒张期充盈减少和对峰值运动的反应受损）。长期生长激素替代疗法可逆转这些异常情况中的大多数。更一致的是，生长激素替代可减少体脂和内脏脂肪组织，降低低密度脂蛋白胆固醇和甘油三酯水平，并改善内皮功能。生长激素替代还可减少主要动脉的内膜中层厚度并改善左心室功能，但这些结果仅在少数短期治疗的患者系列中观察到。本综述讨论了GHD和生长激素替代疗法在心血管疾病发展中的作用。
