Читать книгу Metabolic Syndrome Consequent to Endocrine Disorders - Группа авторов - Страница 16

Adults with GHD have unfavorable lipid profiles characterized by increased total and LDL cholesterol and triglycerides, while decreased HDL was observed only in women [27]. GHRT significantly improves lipid profiles in these patients [27–33]. Significant decrease in total and LDL cholesterol and increase in HDL cholesterol during short- (1–2 years) and long-term (5–15 years) GHRT were reported [28–31]. GHRT may also lower triglycerides although in meta-analysis, including 37 trials, positive effect of GHRT was confirmed only on total and LDL cholesterol [32]. The effect on triglycerides was neutral [32].

Small dense LDL, which may be an independent cardiovascular risk factor, is also common in GHD patients, but GHRT did not affect size of LDL particles [34–36]. Oxidative stress plays an important role in pathogenesis of atherosclerosis mediated by lipid peroxidation in particular of LDL. Oxidative stress is increased in GHD and improves with GHRT [37]. Increase in oxidated LDL was also observed and short-term GHRT was able to reduce lipid peroxidation in GHD [38, 39]. Finally, additive effect of combined statin and GH replacement treatment was observed in these patients [40].

Fig. 1. Pathogenesis of metabolic syndrome (MetS) and its components in patients with hypopituitarism and growth hormone deficiency. Used with permission from Lancet Oncology, reference number 4177570097030 [104].