1
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Silvestrini A, Mancini A. The Double-Edged Sword of Total Antioxidant Capacity: Clinical Significance and Personal Experience. Antioxidants (Basel) 2024; 13:933. [PMID: 39199179 PMCID: PMC11351343 DOI: 10.3390/antiox13080933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 09/01/2024] Open
Abstract
Oxidative stress (OS) could be a condition underlying several human diseases, despite the physiological role of reactive oxygen species (oxidative eustress). Therefore, antioxidant compounds could represent a modulatory mechanism for maintaining a proper redox balance and redox signaling. When antioxidants are insufficient or overwhelmed, OS ensues, causing multiple damages at molecular, tissue, and cellular levels. This study focuses on the role of total antioxidant capacity (TAC) as a biomarker to be interpreted according to several clinical scenarios. After a brief description of various assay methods to elucidate terminology and physiopathological roles, we focus on the hormonal influence on TAC in blood plasma and other biological fluids, as different endocrine systems can modulate the antioxidant response. Furthermore, OS characterizes several endocrinopathies through different mechanisms: an inadequate antioxidant response to an increase in reducing equivalents (reductive distress) or a marked consumption of antioxidants (oxidative distress), which leads to low TAC values. An increased TAC could instead represent an adaptive mechanism, suggesting a situation of OS. Hence, the clinical context is fundamental for a correct interpretation of TAC. This review aims to provide the reader with a general overview of oxidative stress in several clinical examples of endocrine relevance, such as metabolic syndrome, non-thyroid illness syndrome, hypopituitarism, and infertility. Finally, the impact of dietary and surgical interventions on TAC in the model of metabolic syndrome is highlighted, along with personal experience.
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Affiliation(s)
- Andrea Silvestrini
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, 00168 Rome, Italy
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2
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Ratku B, Sebestyén V, Erdei A, Nagy EV, Szabó Z, Somodi S. Effects of adult growth hormone deficiency and replacement therapy on the cardiometabolic risk profile. Pituitary 2022; 25:211-228. [PMID: 35106704 PMCID: PMC8894188 DOI: 10.1007/s11102-022-01207-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/12/2022]
Abstract
Adult growth hormone deficiency (AGHD) is considered a rare endocrine disorder involving patients with childhood-onset and adult-onset growth hormone deficiency (AoGHD) and characterized by adverse cardiometabolic risk profile. Besides traditional cardiovascular risk factors, endothelial dysfunction, low-grade inflammation, impaired adipokine profile, oxidative stress and hypovitaminosis D may also contribute to the development of premature atherosclerosis and higher cardiovascular risk in patients with AGHD. Growth hormone replacement has been proved to exert beneficial effects on several cardiovascular risk factors, but it is also apparent that hormone substitution in itself does not eliminate all cardiometabolic abnormalities associated with the disease. Novel biomarkers and diagnostic techniques discussed in this review may help to evaluate individual cardiovascular risk and identify patients with adverse cardiometabolic risk profile. In the absence of disease-specific guidelines detailing how to assess the cardiovascular status of these patients, we generally recommend close follow-up of the cardiovascular status as well as low threshold for a more detailed evaluation.
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Affiliation(s)
- Balázs Ratku
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
- Department of Emergency and Oxyology, Faculty of Health, University of Debrecen, Debrecen, Hungary
| | - Veronika Sebestyén
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Annamária Erdei
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Endre V Nagy
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Szabó
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary
| | - Sándor Somodi
- Department of Emergency Medicine, Faculty of Medicine, University of Debrecen, Egyetem tér 1, Debrecen, 4032, Hungary.
- Division of Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
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3
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Mancini A, Guidi F, Bruno C, Angelini F, Vergani E, Lanza P, Mordente A, Meucci E, Silvestrini A. Can plasma antioxidants prevent DNA damage in oxidative stress condition induced by growth hormone deficiency? A pilot study. PLoS One 2021; 16:e0248971. [PMID: 33793606 PMCID: PMC8016303 DOI: 10.1371/journal.pone.0248971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 03/05/2021] [Indexed: 11/19/2022] Open
Abstract
Adult growth hormone deficiency (GHD), a condition characterized by increased oxidative stress, is related to augmented cardiovascular, metabolic and oncological risk. A case-control observational study has been performed to evaluate DNA oxidative damage analysing the production of thymidine-glycol in lymphocytes and its correlation with plasma antioxidant levels, evaluated as Total Antioxidant Capacity (TAC). GHD was diagnosed using GHRH 50μg iv+arginine 0,5 g/Kg test, with peak GH response <9 μg/L when BMI was <30 kg/m2 or <4 μg/L when BMI was >30 kg/m2. Three groups were identified: total GHD (n = 16), partial GHD (n = 11), and controls (n = 12). Thymidine-glycol, TAC and IGF-1 have been determined respectively in lymphocytes, plasma and serum samples. When considering thymidine-glycol, we found a significant difference between total vs partial GHD and controls. Unexpectedly thymidine-glycol was lower in total GHD, also accompanied with a significant increase in plasmatic TAC. Our results showed that in adult GHD condition, the production of antioxidant species, in response to increased oxidative stress, could exert a protective effect on thymidine-glycol formation, and consequently on DNA intracellular damages. This pilot study could be inserted in the complex scenario of oxidative damage of GHD, a subtle, yet poorly defined condition, worthy of further insights.
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Affiliation(s)
- Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Francesco Guidi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Flavia Angelini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Lanza
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alvaro Mordente
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisabetta Meucci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Silvestrini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, Cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome, Italy
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4
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Mancini A, Bruno C, Vergani E, Guidi F, Angelini F, Meucci E, Silvestrini A. Evaluation of oxidative stress effects on different macromolecules in adult growth hormone deficiency. PLoS One 2020; 15:e0236357. [PMID: 32687509 PMCID: PMC7371168 DOI: 10.1371/journal.pone.0236357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 07/03/2020] [Indexed: 12/17/2022] Open
Abstract
Adult growth hormone deficiency (GHD) is being increasingly recognized to cause premature mortality exacerbated by oxidative stress. A case-control observational study has been performed with the primary objective of evaluating new parameters of oxidative stress and macromolecular damage in adult GHD subjects: serum nitrotryptophan; Total Antioxidant Capacity expressed as LAG time; urinary hexanoil-lysine; urinary dityrosine and urinary 8-OH-deoxyguanosine. GHD was diagnosed using Growth Hormone-Releasing Hormone 50μg iv+arginine 0,5 g/Kg test, with a peak GH response <9 μg /L when BMI was <30 kg/m2 or <4 μg/L when BMI was >30 kg/m2. Patients affected by adult GHD were divided into three groups, total GHD (n = 26), partial GHD (n = 25), and controls (n = 29). Total Antioxidant Capacity, metabolic and hormonal parameters have been determined in separate plasma samples; nitrotryptophan in serum samples; hexanoil-lysine, dityrosine, 8-OH-deoxyguanosine in urine samples. Assessment of hexanoil-lysine exhibited a trend to increase in comparing total GHD vs partial and controls, although not significant. Values of 8-OH-deoxyguanosine did not significantly differ among the three groups. Significant lower levels of dityrosine in partial GHD vs total and controls were found. No significant difference in nitrotriptophan serum levels was found, while significantly greater values of Total Antioxidant Capacity were showed in total and partial GHD vs controls. Thus, our result confirm that oxidative stress is increased both in partial and total adult GHD. The lack of compensation by antioxidants in total GHD may be connected to the complications associated to this rare disorder.
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Affiliation(s)
- Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - Francesco Guidi
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - Flavia Angelini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
| | - Elisabetta Meucci
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Silvestrini
- Fondazione Policlinico Universitario A, Gemelli IRCCS, Rome, Italy
- Dipartimento di Scienze biotecnologiche di base, cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome, Italy
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5
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Vergani E, Bruno C, Silvestrini A, Meucci E, Proietti L, Perna A, Tamburrelli FC, Mancini A. Oxidative stress and anabolic hormones in back pain: Current concept and preliminary analysis in male cohort. Orthop Rev (Pavia) 2020; 12:8686. [PMID: 32913614 PMCID: PMC7459380 DOI: 10.4081/or.2020.8686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 01/22/2023] Open
Abstract
Back Pain (BP) is a common medical problem; anabolic hormones, through the modulation of oxidative stress (OS), could influence fracture risk. We evaluated the prevalence of anabolic hormonal deficiencies and their relationship with OS in males with BP, associated or not to nontraumatic fractures. 49 males with BP, from 36 to 80 years, were divided in two groups according to radiological evidence of nontraumatic fractures; group A (n=25): non-fractured; group B (n=24): fractured. A different prevalence of hormonal deficits was observed: 24% of hypotestosteronemia in A, 0% in B; 16% of GHD in A, 29% in B; Total Antioxidant Capacity (TAC) showed a trend toward higher levels in B. In A, despite lower TAC, a significant inverse correlation was present between TAC and IGF-1. A greater prevalence of GHD in patients with vertebral fractures was seen and, in a subgroup, OS could mediate the deleterious effects of hyposecretory GH state.
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Affiliation(s)
- Edoardo Vergani
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Carmine Bruno
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
| | - Andrea Silvestrini
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Dipartimento di Scienze Biotecnologiche di base, cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome
| | - Elisabetta Meucci
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Dipartimento di Scienze Biotecnologiche di base, cliniche intensivologiche e peri-operatorie, Università Cattolica del Sacro Cuore, Rome
| | - Luca Proietti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Dipartimento di Scienze geriatriche e ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Perna
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Dipartimento di Scienze geriatriche e ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Ciro Tamburrelli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.,Dipartimento di Scienze geriatriche e ortopediche, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Mancini
- Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome
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6
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Araújo IMP, Albuquerque-Souza E, Aguiar-Oliveira MH, Holzhausen M, Oliveira-Neto LA, Salvatori R, Saraiva L, Mayer MPA, Pannuti CM, Ribeiro AO, Romito GA, Pustiglioni FE. Immunological and microbiological periodontal profiles in isolated growth hormone deficiency. J Periodontol 2018; 89:1351-1361. [PMID: 29797719 DOI: 10.1002/jper.17-0687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/09/2018] [Accepted: 04/29/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Growth hormone (GH) has been identified as an important regulator of the immune response. We have previously shown that adults with isolated GH deficiency (IGHD) due to a mutation in the GH releasing hormone receptor (GHRHR) gene, have a greater chance of having periodontitis. However, the interaction of GH with periodontal tissues is still unknown, and this population has emerged as a unique model to investigate this issue. Therefore, we evaluated the microbiological and immunological periodontal profiles of such individuals. METHODS Nineteen IGHD and 19 controls matched by age, sex, diabetes, and smoking status, were enrolled in this case-control study. Periodontal clinical parameters (probing depth [PD] and clinical attachment loss [AL]) were measured at six sites per tooth. Immune mediators (C-reactive protein, matrix metalloproteinase [MMP]-8, MMP-9, interleukin [IL]-1α, IL-6, IL-8, tumor necrosis factor [TNF]-α, adiponectin, and leptin) were analyzed by enzyme-linked immunosorbent assay (ELISA) in the gingival crevicular fluid (GCF) in four non-adjacent sites for each participant (two with PD ≤3 mm [shallow sites] and two with PD ≥7 mm or the worst PD found in the mouth [deep sites]). Bacterial quantification (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) of subgingival biofilm samples collected from these same sites was performed by quantitative real-time polymerase chain reaction (qPCR). RESULTS IGHD individuals presented higher values of PD and AL, and increased levels of CRP, IL-8, MMP-8, and adiponectin in the GCF. Bacterial quantification did not identify differences between the two groups. CONCLUSION IGHD alters the local immune response in periodontal pockets leading to greater attachment loss, and GH stands out as an important hormone to be evaluated in the pathogenesis of periodontitis.
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Affiliation(s)
- I M P Araújo
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - E Albuquerque-Souza
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M H Aguiar-Oliveira
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - M Holzhausen
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - L A Oliveira-Neto
- Division of Endocrinology, Federal University of Sergipe, 49060-100, Aracaju, SE, Brazil
| | - R Salvatori
- Division of Endocrinology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - L Saraiva
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - M P A Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, SP, Brazil
| | - C M Pannuti
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - A O Ribeiro
- Federal University of Sergipe, Division of Immunology and Molecular Biology Laboratory, SE, Brazil
| | - G A Romito
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
| | - F E Pustiglioni
- Division of Periodontics, School of Dentistry, University of São Paulo, SP, Brazil
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Giagulli VA, Castellana M, Perrone R, Guastamacchia E, Iacoviello M, Triggiani V. GH Supplementation Effects on Cardiovascular Risk in GH Deficient Adult Patients: A Systematic Review and Meta-analysis. Endocr Metab Immune Disord Drug Targets 2018; 17:285-296. [PMID: 28925898 PMCID: PMC5925873 DOI: 10.2174/1871530317666170919121729] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/30/2017] [Accepted: 09/07/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVE The current meta-analysis aims at evaluating whether the existing clinical evidence may ascertain the effects of growth hormone (GH) replacement therapy on cardiovascular risk, both in isolated GH deficiency (GHD) and in compensated panhypopituitarism including GH deficit. METHODS Original articles published from 1991 to 2015 were searched on Medline (Pubmed). Among an overall number of 181 potentially suitable studies, 24 fulfilled the selection criteria and were included in the analysis. Data aggregation was carried out through the calculation of the absolute risk reduction. The meta-analysis was then conducted by means of a fixed-effects model, according to the heterogeneity test (Chi-square statistic). RESULTS Fat-free mass (FFM) increase and fat mass (FM) reduction were found, together with a C-LDL reduction, a wide variation in glycaemia and a neutral effect on glycated haemoglobin (HbA1c) and blood pressure. These effects were valid both for isolated GHD patients and for those with compensated panhypopituitarism. The global outcome D showed a nonsignificant reduction of the overall cardiovascular risk (0.53; 95% C.I. -1.23, 2.85). CONCLUSION Our meta-analysis shows no signnificatly positive trend in cardiovascular risk after both short and long-term GH supplementation therapy in adult GHD patients. However, a reduction of LDL cholesterol levels has been found. No differences were found between isolated GHD participants and those affected by panhypopituitarism well compensated since at least 3 months.
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Affiliation(s)
- Vito A Giagulli
- Outpatient Clinic for Endocrinology and Metabolic Diseases, Conversano Hospital, ASL Bari Via De Amicis, 70014 Conversano, Italy.,Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "A. Moro", Bari, Italy
| | - Marco Castellana
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | | | - Edoardo Guastamacchia
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "A. Moro", Bari, Italy
| | - Massimo Iacoviello
- Cardiology Unit, Cardiothoracic Department, University of Bari, School of Medicine, Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "A. Moro", Bari, Italy
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8
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Mancini A, Di Segni C, Bruno C, Olivieri G, Guidi F, Silvestrini A, Meucci E, Orlando P, Silvestri S, Tiano L, Pontecorvi A. Oxidative stress in adult growth hormone deficiency: different plasma antioxidant patterns in comparison with metabolic syndrome. Endocrine 2018; 59:130-136. [PMID: 29143180 DOI: 10.1007/s12020-017-1468-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/02/2017] [Indexed: 01/13/2023]
Abstract
BACKGROUND AND AIMS Growth hormone deficiency (GHD) is a condition associated with increased cardiovascular risk and insulin-resistance. Oxidative stress (OS) could be a mechanism underlying both these phenomena. In order to investigate plasma antioxidant defenses in such condition, we evaluated adults with GHD, compared with controls and metabolic syndrome patients (MetS), studying plasma total antioxidant capacity (TAC) and coenzyme Q10 (CoQ10, lipophilic antioxidant) levels, both in its oxidized and reduced forms, correlating this data with metabolic and hormonal pattern. MATERIALS AND METHODS In this case-control study, 51 GHD, 36 controls, and 35 MetS were enrolled. An evaluation of hormonal and metabolic parameters was performed. TAC was measured using the system metmyoglobin -H202 and the chromogen ABTS, whose radical form is spectroscopically revealed; latency time (LAG) in the appearance of ABTS● is proportional to antioxidant in sample. CoQ10 was assayed by electrochemical method. RESULTS Despite HOMA index was higher in both GHD and MetS (2.2 ± 0.3 and 3.1 ± 0.3 vs. 1.2 ± 0.2 in controls), only in MetS we observed lower LAG levels (64.5 ± 3.1 s vs. 82.8 ± 5.8 in GHD and 80.6 ± 6.6 in controls), suggesting an increased consumption of antioxidants. LAG significantly correlated with uric acid only in MetS (r 2 = 0.65, p < 0.001), suggesting a different pattern of antioxidants. CoQ10 exhibited a trend toward lower levels in GHD, although not significant. CONCLUSIONS Our data indicate that GHD, although sharing with MetS various metabolic features, including increased HOMA levels, showed a different pattern of plasma antioxidants, suggesting inadequate reactivity toward radical production rather than an antioxidants consumption as in MetS.
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Affiliation(s)
- Antonio Mancini
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy.
| | - Chantal Di Segni
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy
| | - Carmine Bruno
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy
| | - Giulio Olivieri
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy
| | - Francesco Guidi
- Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy
| | - Andrea Silvestrini
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Largo F. Vito 1, Rome, 00168, Italy.
| | - Elisabetta Meucci
- Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Largo F. Vito 1, Rome, 00168, Italy
| | - Patrick Orlando
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, 60131, Italy
| | - Sonia Silvestri
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, 60131, Italy
| | - Luca Tiano
- Department of Life and Environmental Sciences, Polytechnic University of Marche, Via Brecce Bianche, Ancona, 60131, Italy
| | - Alfredo Pontecorvi
- Operative Unit of Endocrinology, Catholic University of the Sacred Heart, Largo A. Gemelli 8, Rome, 00168, Italy
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9
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Stochholm K, Johannsson G. Reviewing the safety of GH replacement therapy in adults. Growth Horm IGF Res 2015; 25:149-157. [PMID: 26117668 DOI: 10.1016/j.ghir.2015.06.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 06/17/2015] [Accepted: 06/17/2015] [Indexed: 02/04/2023]
Abstract
CONTEXT Systematic data on safety of growth hormone (GH) replacement therapy in adult GH deficiency is lacking. OBJECTIVE To systematically describe safety of adult GH replacement therapy on glucose metabolism and long term safety. DESIGN A systematic web-based search of PubMed was performed guided by the Standard Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). OUTCOME Randomised controlled trials of ≥3 months and open trials for ≥12 months with more than 50 adult patients (50 patient years, prospective and retrospective) including adverse event reporting as well as articles on mortality primarily on adult onset patients, reporting mortality ratios on GH treated patients, were included for the review. RESULTS Based on the defined selection criteria 94 studies were included. The short-term early placebo controlled trials did not demonstrate an increased frequency of diabetes mellitus (DM) and the long-term open studies did not consistently show an increased incidence of DM during GH replacement. The concern that long-term GH replacement might increase the risk of primary cancer, secondary neoplasia after tumour treatment and recurrence of previous tumours was not evident in the study data. CONCLUSION Based on available data, short- and long-term adult GH replacement in patients with severe GH deficiency and hypopituitarism is safe. However, the small number of subjects, limitation of long-term of GH treatment data and absence of an adequate control population is still a limitation for the interpretation of these data.
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Affiliation(s)
- Kirstine Stochholm
- Department of Internal Medicine and Endocrinology, Aarhus University Hospital, 8000, Aarhus C, Denmark
| | - Gudmundur Johannsson
- Department of Endocrinology, Grstr 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden; Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Grstr 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden
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10
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González-Duarte D, Madrazo-Atutxa A, Soto-Moreno A, Leal-Cerro A. Measurement of oxidative stress and endothelial dysfunction in patients with hypopituitarism and severe deficiency adult growth hormone deficiency. Pituitary 2012; 15:589-97. [PMID: 22228310 DOI: 10.1007/s11102-011-0374-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Patients with adult GH deficiency (AGHD) have a high cardiovascular risk and probably an alteration of the oxidative balance, although evidence is lacking. To evaluate the presence of endothelial dysfunction and oxidative stress in patients with AGHD. Biochemical parameters of oxidative stress and endothelial dysfunction were compared in 25 patients with previously untreated AGHD and 25 healthy controls matched by age and sex. Multivariate analysis was performed to identify independent predictors of oxidative stress. Vascular function of subcutaneous resistance arteries was also analyzed by means of wire myography in 7 patients with untreated AGHD and in 7 healthy controls with similar characteristics. The values of C-reactive protein, interleukin-6 (IL-6) and tumour necrosis factor alpha (TNF-α), were higher in the AGHD group (4.6 vs. 0.2 μg/L, P = 0.02; 5.6 vs. 1.2 pg/mL, P = 0.001; 6.7 vs. 2.1 pg/mL, P = 0.04; respectively). The levels of type-1 vascular cell adhesion molecule, total anti-oxidant state, oxidized LDL (LDL-ox) were also greater in AGHD patients (678 vs. 423 ng/mL, P = 0.004; 1235.6 vs. 1002.3 μmol/L, P = 0.01; 172.2.5 vs. 42.3 ng/mL, P = 0.02; respectively). Nitric oxide (NO), reduced glutathione (GSH) and reduced/oxidized glutathione ratio (GSH/GSSG) values were lower than controls (18.7 vs. 31.6 mmol/mg protein, P = 0.01; 372.2 vs. 756.2 μmol/L, P = 0.03; 17.2 vs. 38.4, P = 0.04; respectively). Multiple regression analysis showed that AGHD was an independent predictor of increased LDL-ox (P = 0.002) and decreased GSH (P = 0.000). Furthermore, the degree of vascular relaxation to repeated exposure of acetylcholine was lower in AGHD (P = 0.025). Patients with AGHD have an increased degree of oxidative stress and endothelial dysfunction that could already be present in early stages of the disease. Studies with a greater number of patients are needed in order to confirm our findings.
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Affiliation(s)
- Daniel González-Duarte
- Endocrinology Unit, Hospital Punta Europa de Algeciras, Carretera Getares, 11204 Algeciras, Cádiz, Spain.
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11
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Mancini A, Festa R, Di Donna V, Leone E, Littarru GP, Silvestrini A, Meucci E, Pontecorvi A. Hormones and antioxidant systems: role of pituitary and pituitary-dependent axes. J Endocrinol Invest 2010; 33:422-33. [PMID: 20631494 DOI: 10.1007/bf03346615] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Oxidative stress, a condition defined as unbalancing between production of free radicals and antioxidant defenses, is an important pathogenetic mechanism in different diseases. Despite the abundant literature, many aspects of hormone role in regulating antioxidant synthesis and activity still remain obscure. Therefore, we reviewed experimental data, in vivo and in vitro, about the effects of the different pituitary- dependent axes on antioxidant levels, trying to give a broad view from hormones which also have antioxidant properties to the classic antioxidants, from the lipophilic antioxidant Coenzyme Q10, strictly related to thyroid function, to total antioxidant capacity, a measure of non-protein non-enzymatic antioxidants in serum and other biological fluids. Taken together, these data underline the importance of oxidative stress in various pituitary-dependent disorders, suggesting a possible clinical usefulness of antioxidant molecules.
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Affiliation(s)
- A Mancini
- Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy.
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12
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Scacchi M, Valassi E, Pincelli AI, Fatti LM, Pecori Giraldi F, Ascoli P, Viarengo R, Cestaro B, Cavagnini F, Cazzola R. Increased lipid peroxidation in adult GH-deficient patients: effects of short-term GH administration. J Endocrinol Invest 2006; 29:899-904. [PMID: 17185899 DOI: 10.1007/bf03349194] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Adult GH deficiency (GHD) syndrome is characterized by increased risk of atherosclerosis and hence of cardio- and cerebrovascular mortality. Oxidative stress appears to play an important role in early atherogenesis. Oxidized LDL represents an important predictor of cardiovascular risk and is mainly responsible for oxidative damage of the endothelium. Its concentrations are increased in GHD, but the association between this abnormality and oxidative stress is still unclear, due to the discordant results yielded by the few available studies. DESIGN AND METHODS In 13 GHD patients, plasma lipid peroxide concentrations were measured before and after a 4-month treatment with recombinant human GH (rhGH) and compared with those of 13 age- and sex-matched controls. In the same subjects, the so-called "lag-time", an index of anti-oxidant activity and thus of plasma oxidative balance, was also measured using a fluorescence kinetics method. RESULTS Before treatment, peroxide levels were significantly higher in patients than in controls (374.0+/-31.52 vs 268.0+/-8.51 U.C., p<0.01), whereas the lag-time was significantly lower (113.0+/-10.70 vs 168.0+/-7.80 min, p<0.01). RhGH administration to patients resulted both in a significant decrease in lipid peroxide levels (from 374.0+/-31.52 to 336.0+/-33.17 U.C., p<0.01) and a significant prolongation of lag-time (from 113.0+/-10.70 to 144.0+/-15.00 min, p<0.01). After treatment, both parameters were no longer significantly different in patients and controls. Lag-time and peroxide levels at baseline did not show any correlation with IGF-I concentrations in GHD patients. After replacement therapy, however, lag-time was positively (r2= 0.62, p<0.01), and peroxide levels negatively (r2=0.41, p<0.05), correlated with IGF-I levels. CONCLUSIONS These data support the view that adult GHD syndrome is characterized by an unbalance between pro- and anti-oxidant factors with marked preponderance of the former. This abnormality, likely contributing to the increased atherogenic risk of GHD patients, is corrected by short-term GH administration at a dose able to increase, although not to fully normalize, IGF-I levels.
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Affiliation(s)
- M Scacchi
- University of Milan, Ospedale San Luca IRCCS, Istituto Auxologico Italiano, Milan, Italy
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13
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Yapicioğlu H, Satar M, Canacankatan N, Tutak E, Sertdemir Y, Antmen E, Narli N. The effect of human growth hormone on superoxide dismutase activity, glutathione and malondialdehyde levels of hypoxic-ischemic newborn rat brain. Neonatology 2006; 90:168-73. [PMID: 16636532 DOI: 10.1159/000092680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 12/19/2005] [Indexed: 11/19/2022]
Abstract
OBJECTIVES We investigated the effect of human growth hormone (GH) on newborn rat brain superoxide dismutase, glutathione and malondialdehyde (MDA) levels in hypoxic-ischemic (H-I) newborn rats. METHODS Fourty-eight 7 days old newborn rats were randomized to a healthy (n: 15), H-I (n: 18) and GH administered H-I (GH-H-I, n: 15) group. Permanent, left common carotid ligation was performed in the H-I groups. In the GH-H-I group, 50 mg/kg human GH (Norditropin Simplex, Novo Nordisk A/S) was administered subcutaneously just before carotid artery ligation. Two hours after ligation, rats were subjected to 2 h of hypoxemia and then were decapitated. Right and left cerebral hemispheres (CHs) and cerebellum-brain stem (C-BS) were separated. RESULTS Glutathione levels of each region were not statistically different from each other in and between the groups. Superoxide dismutase levels were higher in C-BSs compared to CHs (for each comparison p < 0.01). CHs and C-BS MDA levels were similar in the control and H-I groups but MDA levels of both CHs of the GH-H-I group were significantly higher than the levels of the H-I group (p = 0.01; p = 0.024, respectively). Left CH MDA level of GH-H-I group was higher compared to left CH MDA of the control group (p = 0.045) while there was no difference between right CHs. In the GH-H-I group, left CH MDA level was higher than the C-BS (p = 0.03). MDA levels of the C-BSs did not differ between the groups (p > 0.05). CONCLUSION Although we have not evaluated the effect of GH histopathologically, increased lipid peroxidation especially in the H-I (left) hemisphere of the GH treated rats might suggest that GH treatment may be harmful in H-I encephalopathy.
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Affiliation(s)
- Hacer Yapicioğlu
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Cukurova University, Adana, Turkey.
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14
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Mohn A, Marzio D, Giannini C, Capanna R, Marcovecchio M, Chiarelli F. Alterations in the oxidant-antioxidant status in prepubertal children with growth hormone deficiency: effect of growth hormone replacement therapy. Clin Endocrinol (Oxf) 2005; 63:537-42. [PMID: 16268806 DOI: 10.1111/j.1365-2265.2005.02378.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Growth hormone deficiency (GHD) in adults is associated with increased oxidative stress determined by the underlying GH-IGF-1 axis alterations. Despite GHD being a common diagnosis in children with short stature, no data on the oxidant/antioxidant status are available in this age group. This study was designed to detect differences in oxidative stress parameters between prepubertal GH-deficient children and healthy controls. Furthermore, the effect of 12 months of conventional GH replacement (rGH) on oxidant-antioxidant status was evaluated in the GHD group only. PATIENTS Ten (nine males and one female) prepubertal children (mean age 9.1 +/- 1.3 years) with GHD were recruited and matched for sex and age (9.2 +/- 1.9 years) with 20 healthy controls (18 males and two females). MEASUREMENTS At study entry, lag phase, an index of susceptibility of low density lipoprotein (LDL) to in vitro oxidation, malondialdehyde (MDA) and vitamin E were measured in all subjects. These parameters were also evaluated in GH-deficient children after 12 months of rGH treatment. RESULTS The lag phase was significantly decreased in GH-deficient children compared to healthy controls (15.50 +/- 7.4 vs. 43.00 +/- 9.2 min; P = 0.0007), while MDA was significantly increased (1.33 +/- 0.38 vs. 0.46 +/- 0.10 nmol/mg; P = 0.0006). Vitamin E levels were significantly decreased (22.44 +/- 9.57 vs. 35.38 +/- 16.49 micromol/l; P = 0.001). IGF-1 and IGFBP-3 correlated directly to lag phase (r = 0.48; P = 0.01; r = 0.63, P = 0.002, respectively) and to vitamin E (r = 0.59, P = 0.003; r = 0.58, P = 0.006, respectively). By contrast, IGF-1 and IGFBP-3 correlated indirectly to MDA (r = -0.47, P = 0.01; r =-0.65, P = 0.002, respectively). After 1 year of rGH therapy, lag phase (39.32 +/- 15.24 min; P = 0.005) and vitamin E (34.9 +/- 7.7 micromol/l; P = 0.005) increased significantly, while MDA decreased significantly (0.71 +/- 0.42 nmol/mg; P = 0.005), reaching normal levels. CONCLUSIONS These data show that children with GHD have substantially increased oxidative stress parameters compared to healthy controls and demonstrate a normalization of these parameters after 1 year of rGH therapy.
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Affiliation(s)
- Angelika Mohn
- Department of Paediatrics, University of Chieti, Italy.
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15
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Colao A, Di Somma C, Vitale G, Filippella M, Lombardi G. Influence of growth hormone on cardiovascular health and disease. ACTA ACUST UNITED AC 2005; 2:347-56. [PMID: 15981951 DOI: 10.2165/00024677-200302050-00006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Experimental and clinical studies indicate that growth hormone (GH) and insulin-like growth factor-1 (IGF-1) are involved in heart development. Impaired cardiovascular function, as recently demonstrated, could potentially reduce life expectancy both in GH deficiency (GHD) and excess. Patients with childhood- or adult-onset GHD may have both cardiac structural and functional abnormalities, i.e. reduced cardiac mass, reduced diastolic filling, and impaired left ventricular response to peak exercise. In addition, GHD patients may present with an increase in vascular intima-media thickness and a higher occurrence of atheromatous plaques that can further aggravate the hemodynamic conditions and contribute to the increased cardiovascular and cerebrovascular risk. However, some evidence has been provided to show that cardiovascular abnormalities can be partially reversed after somatropin (recombinant GH) therapy in patients with GHD. Recently, somatropin administration was shown to induce improvement in hemodynamics and clinical status in some patients with heart failure. Although these data need to be confirmed in more extensive studies, such promising results open new perspectives for somatropin therapy. The role of GH secretagogues in heart failure is still unknown.
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Affiliation(s)
- Annamaria Colao
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University, Naples, Italy.
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16
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Colao A. Cardiovascular Effects of Growth Hormone Treatment: Potential Risks and Benefits. Horm Res Paediatr 2004; 62 Suppl 3:42-50. [PMID: 15539798 DOI: 10.1159/000080498] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Growth hormone (GH) and insulin-like growth factor-I are involved in heart development and in maintaining cardiac structure and performance. Cardiovascular disease has been reported to reduce life expectancy both in GH deficiency (GHD) and in GH excess. Patients with GHD suffer from abnormalities of left ventricular performance, i.e. reduced diastolic filling and impaired response to peak exercise. Patients with GHD also have increased intima-media thickness at the common carotid arteries, associated with a higher occurrence of atherosclerotic plaques, which may further aggravate the haemodynamic conditions. This may contribute to increased cardiovascular and cerebrovascular risk. These cardiovascular abnormalities can be reversed, at least partially, with GH replacement therapy. In recent years, GH therapy has been used to increase cardiac mass in ischaemic or dilated cardiomyopathy, but the results have produced contradictory data.
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Affiliation(s)
- Annamaria Colao
- Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Naples, Italy.
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Kahl S, Elsasser TH. Endotoxin challenge increases xanthine oxidase activity in cattle: effect of growth hormone and vitamin E treatment. Domest Anim Endocrinol 2004; 26:315-28. [PMID: 15063924 DOI: 10.1016/j.domaniend.2003.12.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Accepted: 12/08/2003] [Indexed: 11/29/2022]
Abstract
In addition to its basic role in the metabolism of purine nucleotides, xanthine oxidoreductase (XOR) is involved in the generation of oxygen-derived free radicals and production and metabolic fate of nitric oxide (NO). Growth hormone (GH) and Vitamin E (E) have been shown previously to modify immune response to infection. Our objective was to determine in heifers the effect of endotoxin challenge (LPS; 3.0 microg/kg BW, i.v. bolus, Escherichia coli 055:B5) on xanthine oxidase (XO) activity in plasma and liver and the modification of this response by daily treatment with recombinant GH (0.1 mg/kg BW, i.m., for 12 days) or GH+E (E: mixed tocopherol, 1000 IU/heifer, i.m., for 5 days). In experiment 1, 16 heifers ( 348.7 +/- 6.1 kg) were assigned to control (C, daily placebo injections), GH, or GH+E treatments and were challenged with two consecutive LPS injections (LPS1 and LPS2, 48 h apart). After LPS1, plasma XO activity increased 290% (P < 0.001) at 3 h, reached peak (430%) at 24 h and returned to basal level by 48 h after LPS2. XO responses (area under the time x activity curve, AUC) were greater after LPS1 than LPS2 (P< 0.001). Total plasma XO responses to LPS (AUC, LPS1+LPS2) were augmented 55% (P < 0.05) over C with GH treatment but diminished to C responses in GH+E. There was a linear relationship (r2 = 0.605, P < 0.001) between total response in plasma XO activity and plasma nitrate + nitrate concentration. In experiment 2, 24 heifers ( 346 +/- 6 kg) were assigned to C or GH treatments and liver biopsy samples were obtained at 0, 3, 6, and 24h after a single LPS challenge. Hepatic XO activities increased 63.3% (P < 0.05) 6 h after single LPS challenge and remained elevated at 24 h (100.1%, P < 0.01) but were not affected by GH treatment. Results indicate that LPS-induced increases in plasma XO activity could be amplified by previous GH treatment but attenuated by E administration. The data also suggest that E may be effective in controlling some mediators of immune response associated with increased production of NO via the effect on XO activity and its production of superoxide anion as well as uric acid.
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Affiliation(s)
- S Kahl
- Growth Biology Laboratory, U.S. Department of Agriculture, Agricultural Research Service, Animal and Natural Resources Institute, Building 200, Room 211E, Beltsville, MD 20705, USA.
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18
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Piersanti M. Growth hormone replacement for patients with adult onset growth hormone deficiency—what have we learned? Neurosurg Focus 2004; 16:E12. [PMID: 15191341 DOI: 10.3171/foc.2004.16.4.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Growth hormone (GH) deficiency is a condition recognized to occur in individuals who have had multiple pituitary hormone deficiencies as a result of pathological processes or neurosurgical interventions. The indications, benefits, and risks of GH replacement therapy will be reviewed with an emphasis on those patients who were adults with the deficiency first emerged. The results of this analysis indicate that, although a measurable improvement can be detected in the patient's quality of life, body composition, and some cardiovascular parameters, the larger questions of long-term benefit and patient selection currently remain unanswered.
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Affiliation(s)
- Monique Piersanti
- Department of Endocrinology, Credit Valley Hospital, Toronto, Ontario, Canada.
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Ozbey N, Telci A, Cakatay U, Yurci A, Molvalilar S. Determination of oxidative protein and lipid damage in adult hypopituitary patients with GH deficiency. J Endocrinol Invest 2003; 26:1001-7. [PMID: 14759074 DOI: 10.1007/bf03348199] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The aim of this study is to determine oxidative protein and lipid damage in adult hypopituitary GH-deficient patients. Eighteen hypopituitary GH-deficient--otherwise healthy-adults on conventional replacement therapy other than GH (9 male, 9 female, age 41.8 +/- 16.4 yr) and 18 healthy subjects (6 male, 12 female, age 40.3 +/- 16.2 yr) participated in the study. Plasma products of oxidative protein damage [protein carbonyl (PCO) and nitrotyrozine (NT)], plasma oxidized LDL (oxLDL), plasma product of oxidative lipid damage [lipid hydroperoxide (LHP)] and antioxidant status of the plasma [total thiol (T-SH)] were measured. Body fat percentage, total and LDL-cholesterol concentrations were significantly higher in the hypopituitary group. Plasma PCO, NT, LHP and T-SH concentrations did not differ significantly between patients and controls. OxLDL concentration was significantly higher in the hypopituitary patients (62.4 +/- 17.8 vs 43.1 +/- 11.3 U/l, p = 0.001). In the patients, oxLDL correlated significantly with the duration of hypopituitarism (r = 0.6323, p = 0.01). In the controls, oxLDL correlated significantly with blood pressure, total and VLDL-cholesterol concentrations. Increased oxLDL concentration may indicate increased oxidative stress within the vascular compartment and may contribute to the proatherogenic state in GH-deficient hypopituitary patients independent from conventional risk factors.
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Affiliation(s)
- N Ozbey
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Istanbul University, Capa, Istanbul, Turkey.
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20
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Yin H, Porter NA. Specificity of the ferrous oxidation of xylenol orange assay: analysis of autoxidation products of cholesteryl arachidonate. Anal Biochem 2003; 313:319-26. [PMID: 12605870 DOI: 10.1016/s0003-2697(02)00621-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Autoxidation of polyunsaturated fatty acids and esters leads to a complex mixture containing hydroperoxides and cyclic peroxides. The oxidation mixture of cholesteryl arachidonate, which has been characterized by a variety of mass spectrometry techniques, was subject to analysis by conventional thiobarbituric acid-reactive substance (TBARS) and ferrous oxidation in xylenol orange (FOX) assays. Our results indicate that the FOX assay is not specific for hydroperoxides. Cyclic peroxides, such as monocyclic peroxides and serial-cyclic peroxides, give a positive FOX response even after triphenylphosphine reduction. We suggest that bicyclic endoperoxides are the major TBARS active compounds present in cholesteryl arachidonate oxidation mixtures. These compounds give a positive FOX assay before reaction with triphenylphosphine but negative TBARS and FOX assays after this reaction. Caution should be exercised when the FOX assay is used to analyze highly oxidized lipids, especially arachidonyl-containing lipids.
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Affiliation(s)
- Huiyong Yin
- Department of Chemistry and Center in Molecular Toxicology, Vanderbilt University, Nashville, TN 37235, USA
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