Title:Growth Hormone, Atherosclerosis and Peripheral Arterial Disease:
Exploring the Spectrum from Acromegaly to Growth Hormone Deficiency
Volume: 22
Issue: 1
Author(s): Herman R, Janez A, Mikhailidis DP, Poredos P, Blinc A, Sabovic M, Bajuk Studen K, Schernthaner GH, Anagnostis P, Antignani PL and Jensterle M*
Affiliation:
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
Keywords:
Growth hormone, insulin-like growth factor 1, cardiovascular risk, atherosclerosis, peripheral arterial disease, acromegaly, growth hormone deficiency.
Abstract: Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) are increasingly recognised
for their role in cardiovascular (CV) physiology. The GH-IGF-1 axis plays an essential role in
the development of the CV system as well as in the complex molecular network that regulates cardiac
and endothelial structure and function. A considerable correlation between GH levels and CV mortality
exists even among individuals in the general population without a notable deviation in the GHIGF-
1 axis functioning. In addition, over the last decades, evidence has demonstrated that pathologic
conditions involving the GH-IGF-1 axis, as seen in GH excess to GH deficiency, are associated with
an increased risk for CV morbidity and mortality. A significant part of that risk can be attributed to
several accompanying comorbidities. In both conditions, disease control is associated with a consistent
improvement of CV risk factors, reduction of CV mortality, and achievement of standardised
mortality ratio similar to that of the general population. Data on the prevalence of peripheral arterial
disease in patients with acromegaly or growth hormone deficiency and the effects of GH and IGF-1
levels on the disease progression is limited. In this review, we will consider the pivotal role of the
GH-IGF-1 axis on CV system function, as well as the far-reaching consequences that arise when disorders
within this axis occur, particularly in relation to the atherosclerosis process.
