Wallaschofski H, Saller B, Spilcke-Liss E, Lerch M M, Lohmann T, Eigenthaler M
Department of Gastroenterology, Endocrinology and Nutrition, University of Greifswald, Friedrich-Loeffler-Strasse 23a, 17487 Greifswald, Germany.
Horm Metab Res. 2006 Oct;38(10):656-61. doi: 10.1055/s-2006-954588.
Patients with growth hormone deficiency (GHD) have abnormalities of cardiac structure and function. Growth hormone replacement (GHR) therapy can induce an increase in cardiac mass and improvement in left ventricular ejection fraction. B-type natriuretic peptide (BNP) levels have been successfully used to identify patients with heart failure and they correlate with both disease severity and prognosis.
To investigate the effect of growth hormone replacement on BNP and inflammatory cardiovascular risk factors in adults with GHD we determined NT-proBNP and high sensitive C-reactive protein (CrP) before, 6 and 12 months after GHR.
Thirty adults (14 males, 16 females) with GHD mean age: 41.7+/-14.5 years (range: 17.2 to 75.4 years) were recruited from the German KIMS cohort (Pfizer's International Metabolic Database).
During 12 months of GHR, a significant increase of IGF-1 (85.4+/-72.1 VS. 172.0+/-98 mug/dl; p=0.0001; IGF-1 SDS mean+/-SD: -3.85+/-3.09 VS. -0.92+/-1.82) was detectable. Mean baseline NT-proBNP was 112+/-130 pg/ml (range: 7 to 562). Twelve patients had normal BNP, whereas 18 revealed NT-proBNP values corresponding to those of patients with heart failure NYHA classification I (n=10), NYHA II (n=6) and NYHA III (n=2), respectively. Baseline BNP levels correlated significantly (p=0.044) with increased baseline CrP values. After 12 months of GHR, a significant decrease (p=0.001) in NT-proBNP levels mean: 68+/-81 pg/ml (range: 5 to 395) was detectable, associated with an improvement in NYHA performance status in 10 of the 18 with increased baseline NT-proBNP.
Based on our study, approximately two-thirds of patients with GHD have increased NT-proBNP levels which may be useful as screening/diagnostic laboratory parameter for heart failure in such patients. GHR therapy decreases BNP levels in most patients with GHD.
生长激素缺乏症（GHD）患者存在心脏结构和功能异常。生长激素替代（GHR）疗法可使心脏质量增加，左心室射血分数改善。B型利钠肽（BNP）水平已成功用于识别心力衰竭患者，且与疾病严重程度和预后均相关。
为研究生长激素替代对成年GHD患者BNP及炎症性心血管危险因素的影响，我们在GHR治疗前、治疗6个月及12个月后测定了NT-proBNP和高敏C反应蛋白（CrP）。
从德国KIMS队列（辉瑞国际代谢数据库）招募了30名成年GHD患者（14名男性，16名女性），平均年龄：41.7±14.5岁（范围：17.2至75.4岁）。
在12个月的GHR治疗期间，可检测到IGF-1显著升高（85.4±72.1对172.0±98μg/dl；p=0.0001；IGF-1 SDS均值±标准差：-3.85±3.09对-0.92±1.82）。NT-proBNP基线均值为112±130 pg/ml（范围：7至562）。12例患者的BNP正常，而18例患者的NT-proBNP值分别对应于纽约心脏病协会（NYHA）心功能分级I级（n=10）、II级（n=6）和III级（n=2）的心力衰竭患者。基线BNP水平与升高的基线CrP值显著相关（p=0.044）。GHR治疗12个月后，可检测到NT-proBNP水平显著降低（p=0.001），均值为68±81 pg/ml（范围：5至395），18例基线NT-proBNP升高的患者中有10例NYHA心功能状态得到改善。
基于我们的研究，约三分之二的GHD患者NT-proBNP水平升高，这可能作为此类患者心力衰竭的筛查/诊断实验室指标。GHR治疗可降低大多数GHD患者的BNP水平。
