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BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER

Yıl 2011, Cilt: 74 Sayı: 1, 1 - 6, 10.11.2011

Öz

Amaç: Kalp ve damar hastalıklarının büyüme hormonu (BH) replasmanı almayan erişkin hipopitüiter (HP) hastalarda mortaliteye
ek katkıda bulunduğu bildirilmektedir. BH eksikliği proaterojenik bir duruma neden olmaktadır. Bu çalışmada BH eksikliği olan
HP hastalarda endotel fonksiyonu ve erken aterosklerotik değişiklikleri 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: Çalışmaya 19 BH almayan HP hasta (9 kadın, 42±16 yaş) ile 19 sağlıklı kontrol (6 kadın, 39±16 yaş) 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 düşüktü (69,0±9,1 vs. 76,1±8,6, p=0,01). Karotis
İMK‟sı hastalarda kontrollere oranla daha yüksek (0,80±0,22 vs. 0,56±0,25, p=0,01), brakiyal arter FMD‟si ise daha düşüktü
(8,8±6,06 vs. 13,5±4,6, p=0,02). Her iki gruptada hasta yaşı ile karotis İMK‟sı arasında anlamlı bir korelasyon mevcuttu ancak
ilişki 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 düşük FMD endotel disfonksiyonunu ortaya koymuştur. Hipopitüiter grupta karotis
İMK‟sı ile yaş arasındaki ilişki daha belirgindi. Bulgularımız HP hastalarda endotel fonksiyonunun bozulduğuna ve yaşlanmanın
ateroskleroz üzerine etkilerinin daha belirgin hal aldığına işaret etmektedir.

Kaynakça

  • Anderson TJ, Elstein E, Haber H, Charbonneau F Comparative study of ACE-inhibition, angiotensin II antagonism, and calcium channel blockade on flow- mediated vasodilation in patients with coronary disease (BANFF Study). J Am Coll Cardiol 2000; 35: 60-66.
  • Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D, Lieberman EH, Ganz P, Creager MA, Yeung AC. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26: 1235-1241.
  • Bates SA, Hoff WV, Jones PJ, Clayton RN. The effect of hypopituitarism on life expectancy. J Clin Endocrinol Metab 1996; 81: 1169-1172.
  • Boger RH, Bode-Boger SM, Frolich JC. The L- arginine-nitric oxide pathway: Role in atherosclerosis and therapeutic implications. Atherosclerosis; 1996; 127: 1-11.
  • Bulow B, Hagmar L, Mikoczy Z, Nordström CH, Erfurth EM. Increased cerebrovascular mortality in patients with hypopituitarism. Clin Endocrinol 1997; 46: 75-81.
  • Capaldo B, Patti L, Oliviero U, Longobardi S, Pardo F, Vitale F, Fazio S, Di Rella F, Biondi B, Lombardi G, Saccà L. Increased arterial intima-media thickness in childhood-onset growth hormone deficiency. J Clin Endocrinol Metab 1997; 82: 1378-1381.
  • Chambless LE, Folsom AR, Davis V, Sharrett R, Heiss G, Sorlie P, Szklo M, Howard G, Evans GW. Risk factors atherosclerosis: Communities Study, 1987-1998. Am J Epidemiol 2002; 155: 38-57. of common carotid
  • Atherosclerosis Risk in
  • Colao A, Di Somma C, Spiezia S, Rota F, Pivonello R, Savastano S, Lombardi G . The natural history of partial Growth Hormone deficiency in adults. A prospective study on the cardiovascularrisk and atherosclerosis. J Clin Endocrinol Metab 2006; 91:2191-2200.
  • Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, Vallance P, Vita J, Vogel R; International Brachial Artery Reactivity Task Force 2002.
  • Guidelines for the Ultrasound Assessment of Endothelial- Dependent Flow-Mediated Vasodilation of the Brachial Artery: A Report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol; 39: 257-265.
  • Cuneo RC, Salomon F, Watts GF, Hesp R, Sönksen PH. Growth hormone treatment improves serum lipids and lipoproteins in adults with growth hormone deficiency. Metabolism 1993; 42: 1519-1523.
  • Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet 1991; 338: 1546-1550.
  • Egashira K, Inou T, Hirooka Y, Yamada A, Urabe Y, Takeshita A. Evidence of impaired endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary angiograms. N Engl J Med 1993; 328: 1659-1664.
  • Erfurth EM, Bülow B, Eskilsson J, Hagmar L. High incidence of cardiovascular disease and increased prevalance of cardiovascular risk factors in women with hypopituitarsim not receiving growth hormone treatment: preliminary results. Growth Horm IGF Res; 9 (suppl A): 1999; 21-24.
  • Evans LM, Davies JS, Anderson RA, Ellis GR, Jackson SK, Lewis MJ, Frenneaux MP, Rees A, Scanlon MF . The effect of GH replacement therapy on endothelial function and oxidative stress in adult growth hormone deficiency. Eur J Endocrinol 2000; 142: 254-262.
  • Evans LM, Davies JS, Goodfellow J, Rees JA, Scanlon MF. Endothelial dysfunction in hypopituitary adults with growth hormone deficiency. Clin Endocrinol 1999; 50: 457-464.
  • Kubes P, Suzuki M, Ganger DN (1991). Nitric oxide: an endogenous modulator of leukocyte adhesion. Proc Natl Acad Sci USA; 1991; 88: 4651-4655.
  • Lehmann ED, Hopkins KD, Weissberger AJ, Gosling RG, Sönksen PH. Aortic distensibility in growth hormone deficient adults. Lancet; 1993; 341: 309.
  • Markussis V, Beshyah SA, Fisher C, Sharp P, Nicolaides AN, Johnston DG. Detection of premature atherosclerosis by high-resolution ultrasonography in symptom-free hypopituitary adults. Lancet; 1992; 340: 1188-1192.
  • Menezes Oliveira JL, Marques-Santos C, Barreto-Filho JA, Ximenes Filho R, de Oliveira Britto AV, Oliveira Souza AH, Prado CM, Pereira Oliveira CR, Pereira RM, Ribeiro Vicente Tde A, Farias CT, Aguiar-Oliveira MH, Salvatori R, 2006.
  • Lack of Evidence of Premature Atherosclerosis in Untreated Severe Isolated Growth Hormone Deficiency Due to a GHRH Receptor Mutation. J Clin Endocrin Metab 91: 2093-2099.
  • Pfeifer M, Verhovec R, Zizek B, Prezelj J, Poredos P, Clayton RN. Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. J Clin Endocrinol Metab 1999; 84: 453-457.
  • Rosen T, Eden S, Larson G, Wilhelmsen L, Bengtsson BA. Cardiovascular risk factors in adult patients with growth hormone deficiency. Acta Endocrinol 1993; 129: 195-200.
  • Rosen T, Bengtsson BA. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 1990; 336: 285-288.
  • Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-madia thickness: anew tool for diagnosis and treatment of cardiovascular risk. J Hypertension 2002; 20: 159-169.
  • Smith JC, Evans LM, Wilkinson I, Goodfellow J, Cockcroft JR, Scanlon MF, Davies JS. Effects of GH replacement on endothelial function and large-artery stiffness in GH-deficient adults: a randomized, double-blind, Endocrinol 2002; 56: 493-501. study. Clin
  • Tomlinson JW, Holden N, Hills RK, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM. The West Midlands Prospective Hypopituitary Study Group: Association between premature mortality and hypopituitarism. Lancet 2001; 357: 425-431.
  • Tsao PS, Theilmeier G, Singer SH, Leung LL, Cooke JP. L-arginine attenuates platelet reactivity in hypercholesterolemic rabbits. Arterioscler Thromb 1994; 14: 1529-1533.
  • Tsukahara H, Gordienko DV, Tonshoff B, Gelato MC, Goligorsky MS. Direct demonstration of insulin-like growth factor-I-induced nitric oxide production by endothelial cells. Kidney Int 1994; 45:598-604.
  • Zeiher AM, Drexler H, Wollschlaeger H, Just H Modulation of coronary vasomotor tone in humans: Progressive endothelial dysfunction with different stages of coronary atherosclerosis. Circulation 1991; 83: 391-401.
Yıl 2011, Cilt: 74 Sayı: 1, 1 - 6, 10.11.2011

Öz

Kaynakça

  • Anderson TJ, Elstein E, Haber H, Charbonneau F Comparative study of ACE-inhibition, angiotensin II antagonism, and calcium channel blockade on flow- mediated vasodilation in patients with coronary disease (BANFF Study). J Am Coll Cardiol 2000; 35: 60-66.
  • Anderson TJ, Uehata A, Gerhard MD, Meredith IT, Knab S, Delagrange D, Lieberman EH, Ganz P, Creager MA, Yeung AC. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol 1995; 26: 1235-1241.
  • Bates SA, Hoff WV, Jones PJ, Clayton RN. The effect of hypopituitarism on life expectancy. J Clin Endocrinol Metab 1996; 81: 1169-1172.
  • Boger RH, Bode-Boger SM, Frolich JC. The L- arginine-nitric oxide pathway: Role in atherosclerosis and therapeutic implications. Atherosclerosis; 1996; 127: 1-11.
  • Bulow B, Hagmar L, Mikoczy Z, Nordström CH, Erfurth EM. Increased cerebrovascular mortality in patients with hypopituitarism. Clin Endocrinol 1997; 46: 75-81.
  • Capaldo B, Patti L, Oliviero U, Longobardi S, Pardo F, Vitale F, Fazio S, Di Rella F, Biondi B, Lombardi G, Saccà L. Increased arterial intima-media thickness in childhood-onset growth hormone deficiency. J Clin Endocrinol Metab 1997; 82: 1378-1381.
  • Chambless LE, Folsom AR, Davis V, Sharrett R, Heiss G, Sorlie P, Szklo M, Howard G, Evans GW. Risk factors atherosclerosis: Communities Study, 1987-1998. Am J Epidemiol 2002; 155: 38-57. of common carotid
  • Atherosclerosis Risk in
  • Colao A, Di Somma C, Spiezia S, Rota F, Pivonello R, Savastano S, Lombardi G . The natural history of partial Growth Hormone deficiency in adults. A prospective study on the cardiovascularrisk and atherosclerosis. J Clin Endocrinol Metab 2006; 91:2191-2200.
  • Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, Vallance P, Vita J, Vogel R; International Brachial Artery Reactivity Task Force 2002.
  • Guidelines for the Ultrasound Assessment of Endothelial- Dependent Flow-Mediated Vasodilation of the Brachial Artery: A Report of the International Brachial Artery Reactivity Task Force. J Am Coll Cardiol; 39: 257-265.
  • Cuneo RC, Salomon F, Watts GF, Hesp R, Sönksen PH. Growth hormone treatment improves serum lipids and lipoproteins in adults with growth hormone deficiency. Metabolism 1993; 42: 1519-1523.
  • Drexler H, Zeiher AM, Meinzer K, Just H. Correction of endothelial dysfunction in coronary microcirculation of hypercholesterolaemic patients by L-arginine. Lancet 1991; 338: 1546-1550.
  • Egashira K, Inou T, Hirooka Y, Yamada A, Urabe Y, Takeshita A. Evidence of impaired endothelium-dependent coronary vasodilation in patients with angina pectoris and normal coronary angiograms. N Engl J Med 1993; 328: 1659-1664.
  • Erfurth EM, Bülow B, Eskilsson J, Hagmar L. High incidence of cardiovascular disease and increased prevalance of cardiovascular risk factors in women with hypopituitarsim not receiving growth hormone treatment: preliminary results. Growth Horm IGF Res; 9 (suppl A): 1999; 21-24.
  • Evans LM, Davies JS, Anderson RA, Ellis GR, Jackson SK, Lewis MJ, Frenneaux MP, Rees A, Scanlon MF . The effect of GH replacement therapy on endothelial function and oxidative stress in adult growth hormone deficiency. Eur J Endocrinol 2000; 142: 254-262.
  • Evans LM, Davies JS, Goodfellow J, Rees JA, Scanlon MF. Endothelial dysfunction in hypopituitary adults with growth hormone deficiency. Clin Endocrinol 1999; 50: 457-464.
  • Kubes P, Suzuki M, Ganger DN (1991). Nitric oxide: an endogenous modulator of leukocyte adhesion. Proc Natl Acad Sci USA; 1991; 88: 4651-4655.
  • Lehmann ED, Hopkins KD, Weissberger AJ, Gosling RG, Sönksen PH. Aortic distensibility in growth hormone deficient adults. Lancet; 1993; 341: 309.
  • Markussis V, Beshyah SA, Fisher C, Sharp P, Nicolaides AN, Johnston DG. Detection of premature atherosclerosis by high-resolution ultrasonography in symptom-free hypopituitary adults. Lancet; 1992; 340: 1188-1192.
  • Menezes Oliveira JL, Marques-Santos C, Barreto-Filho JA, Ximenes Filho R, de Oliveira Britto AV, Oliveira Souza AH, Prado CM, Pereira Oliveira CR, Pereira RM, Ribeiro Vicente Tde A, Farias CT, Aguiar-Oliveira MH, Salvatori R, 2006.
  • Lack of Evidence of Premature Atherosclerosis in Untreated Severe Isolated Growth Hormone Deficiency Due to a GHRH Receptor Mutation. J Clin Endocrin Metab 91: 2093-2099.
  • Pfeifer M, Verhovec R, Zizek B, Prezelj J, Poredos P, Clayton RN. Growth hormone (GH) treatment reverses early atherosclerotic changes in GH-deficient adults. J Clin Endocrinol Metab 1999; 84: 453-457.
  • Rosen T, Eden S, Larson G, Wilhelmsen L, Bengtsson BA. Cardiovascular risk factors in adult patients with growth hormone deficiency. Acta Endocrinol 1993; 129: 195-200.
  • Rosen T, Bengtsson BA. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet 1990; 336: 285-288.
  • Simon A, Gariepy J, Chironi G, Megnien JL, Levenson J. Intima-madia thickness: anew tool for diagnosis and treatment of cardiovascular risk. J Hypertension 2002; 20: 159-169.
  • Smith JC, Evans LM, Wilkinson I, Goodfellow J, Cockcroft JR, Scanlon MF, Davies JS. Effects of GH replacement on endothelial function and large-artery stiffness in GH-deficient adults: a randomized, double-blind, Endocrinol 2002; 56: 493-501. study. Clin
  • Tomlinson JW, Holden N, Hills RK, Wheatley K, Clayton RN, Bates AS, Sheppard MC, Stewart PM. The West Midlands Prospective Hypopituitary Study Group: Association between premature mortality and hypopituitarism. Lancet 2001; 357: 425-431.
  • Tsao PS, Theilmeier G, Singer SH, Leung LL, Cooke JP. L-arginine attenuates platelet reactivity in hypercholesterolemic rabbits. Arterioscler Thromb 1994; 14: 1529-1533.
  • Tsukahara H, Gordienko DV, Tonshoff B, Gelato MC, Goligorsky MS. Direct demonstration of insulin-like growth factor-I-induced nitric oxide production by endothelial cells. Kidney Int 1994; 45:598-604.
  • Zeiher AM, Drexler H, Wollschlaeger H, Just H Modulation of coronary vasomotor tone in humans: Progressive endothelial dysfunction with different stages of coronary atherosclerosis. Circulation 1991; 83: 391-401.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Klinik Araştırma
Yazarlar

Hüseyin Oflaz Bu kişi benim

Alper Yurci Bu kişi benim

Burak Pamukçu Bu kişi benim

Binnur Pınarbaşı Bu kişi benim

Sami Uzun Bu kişi benim

Neşe Özbey Bu kişi benim

Yayımlanma Tarihi 10 Kasım 2011
Gönderilme Tarihi 10 Kasım 2011
Yayımlandığı Sayı Yıl 2011 Cilt: 74 Sayı: 1

Kaynak Göster

APA Oflaz, H., Yurci, A., Pamukçu, B., Pınarbaşı, B., vd. (2011). BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER. Journal of Istanbul Faculty of Medicine, 74(1), 1-6.
AMA Oflaz H, Yurci A, Pamukçu B, Pınarbaşı B, Uzun S, Özbey N. BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER. İst Tıp Fak Derg. Kasım 2011;74(1):1-6.
Chicago Oflaz, Hüseyin, Alper Yurci, Burak Pamukçu, Binnur Pınarbaşı, Sami Uzun, ve Neşe Özbey. “BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER”. Journal of Istanbul Faculty of Medicine 74, sy. 1 (Kasım 2011): 1-6.
EndNote Oflaz H, Yurci A, Pamukçu B, Pınarbaşı B, Uzun S, Özbey N (01 Kasım 2011) BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER. Journal of Istanbul Faculty of Medicine 74 1 1–6.
IEEE H. Oflaz, A. Yurci, B. Pamukçu, B. Pınarbaşı, S. Uzun, ve N. Özbey, “BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER”, İst Tıp Fak Derg, c. 74, sy. 1, ss. 1–6, 2011.
ISNAD Oflaz, Hüseyin vd. “BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER”. Journal of Istanbul Faculty of Medicine 74/1 (Kasım 2011), 1-6.
JAMA Oflaz H, Yurci A, Pamukçu B, Pınarbaşı B, Uzun S, Özbey N. BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER. İst Tıp Fak Derg. 2011;74:1–6.
MLA Oflaz, Hüseyin vd. “BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER”. Journal of Istanbul Faculty of Medicine, c. 74, sy. 1, 2011, ss. 1-6.
Vancouver Oflaz H, Yurci A, Pamukçu B, Pınarbaşı B, Uzun S, Özbey N. BÜYÜME HORMONU YETERSİZLİĞİ OLAN HASTALARDA ERKEN ATEROSKLEROTİK DEĞİŞİKLİKLER. İst Tıp Fak Derg. 2011;74(1):1-6.

Contact information and address

Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE

Email: itfdergisi@istanbul.edu.tr

Phone: +90 212 414 21 61