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Horm Metab Res 2006; 38(10): 656-661
DOI: 10.1055/s-2006-954588
Original Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Effects of Growth Hormone Treatment on B-type Natriuretic Peptide as a Marker of Heart Failure in Adults with Growth Hormone Deficiency

H. Wallaschofski 1 , B. Saller 2 , E. Spilcke-Liss 1 , M. M. Lerch 1 , T. Lohmann 3 , M. Eigenthaler 4
  • 1Department of Gastroenterology, Endocrinology and Nutrition, University of Greifswald, Germany (on behalf of the German KIMS board)
  • 2Pfizer GmbH Endocrinology & Diabetology, Karlsruhe, Germany (on behalf of the German KIMS board)
  • 3Department of Internal Medicine, Krankenhaus Dresden Neustadt, Germany
  • 4Institute of Clinical Biochemistry and Pathobiochemistry, University of Würzburg, Germany
Further Information

Publication History

Received 17 October 2005

Accepted after second revision 13 March 2006

Publication Date:
30 October 2006 (online)

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Abstract

Objective: 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. Design: 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. Patients: 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). Results: During 12 months of GHR, a significant increase of IGF-1 (85.4±72.1 vs. 172.0±98 μg/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. Conclusions: 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.

Key words

Growth hormone deficiency - heart failure - BNP - IGF-1

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1 Study Sponsor
The German KIMS board provided support for the random assignment of patients, and partial grant support for the determination of plasma samples.

Correspondence

Henri WallaschofskiMD 

Department of Gastroenterology, Endocrinology and Nutrition·University of Greifswald

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17487 Greifswald

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Phone: +49/3834/86 72 31

Fax: +49/9131/86 72 34

Email: henri.wallaschofski@uni-greifswald.de