Journal of Clinical Endocrinology & Metabolism, Vol 81, 2448-2454, Copyright © 1996 by Endocrine Society

ARTICLES

Low density lipoprotein particle size in hypopituitary adults receiving conventional hormone replacement therapy

D O'Neal, FL Hew, K Sikaris, G Ward, F Alford and JD Best
University of Melbourne, Department of Medicine, St. Vincent's Hospital, Fitzroy, Australia.

Adults receiving conventional replacement therapy for hypopituitarism are known to have increased cardiovascular mortality. The aim of this study was to assess the lipid profiles of 30 hypopituitary adults compared with 2 case control groups, 1 matched for age, sex, and body mass index (BMI) and the second matched for age and sex only with a BMI representative of the general population. Fasting lipids, lipoproteins, and apoproteins (Apo) were determined by routine methods. Low density lipoprotein (LDL) particle size was determined by nondenaturing gradient gel electrophoresis. LDL size was significantly smaller in the hypopituitary group (25.9 +/- 0.1 nm) than in the BMI-matched (26.2 +/- 0.1 nm; P < 0.05) and standard control (26.3 +/- 0.1 nm; P < 0.01) groups. High density lipoprotein cholesterol levels in the hypopituitary group were significantly lower than those in the BMI- matched control group (1.13 +/- 0.06 vs. 1.34 +/- 0.06 mmol/L; P < 0.05) and the standard control group (1.38 +/- 0.06 mmol/L; P < 0.005). Apo A1 levels were also lower compared with those in the BMI-matched (122 +/- 6 vs. 137 +/- 4 mg/dL; P < 0.05) and the standard (143 +/- 4 mg/dL; P < 0.005) control groups. There was a trend toward higher triglyceride levels when the hypopituitary subjects were compared with the standard control group [1.4 (95% CI, 1.3-2.2) vs. 1.0 (95% CI, 0.9- 1.4) mmol/L; P = 0.06]. These differences were more marked in the female subjects studied. No significant differences were noted in total cholesterol, LDL cholesterol, or Apo B levels. We conclude that hypopituitary patients receiving conventional replacement therapy have an atherogenic lipid profile characterized by small dense LDL, decreased high density lipoprotein cholesterol, and increased triglyceride levels, which may contribute to the excess cardiovascular mortality in this group.

This article has been cited by other articles:

				E. R Christ, M. H Cummings, M. Stolinski, N. Jackson, P. J Lumb, A. S Wierzbicki, P. H Sonksen, D. L Russell-Jones, and A M. Umpleby Low-density lipoprotein apolipoprotein B100 turnover in hypopituitary patients with GH deficiency: a stable isotope study. Eur. J. Endocrinol., March 1, 2006; 154(3): 459 - 466. [Abstract] [Full Text] [PDF]

				E. R. Christ, M. H. Cummings, N. Jackson, M. Stolinski, P. J. Lumb, A. S. Wierzbicki, P. H. Sonksen, D. L. Russell-Jones, and A. M. Umpleby Effects of Growth Hormone (GH) Replacement Therapy on Low-Density Lipoprotein Apolipoprotein B100 Kinetics in Adult Patients with GH Deficiency: A Stable Isotope Study J. Clin. Endocrinol. Metab., April 1, 2004; 89(4): 1801 - 1807. [Abstract] [Full Text] [PDF]

				T. B. Twickler, M. J. M. Cramer, G. M. Dallinga-Thie, M. J. Chapman, D. W. Erkelens, and H. P. F. Koppeschaar Adult-Onset Growth Hormone Deficiency: Relation of Postprandial Dyslipidemia to Premature Atherosclerosis J. Clin. Endocrinol. Metab., June 1, 2003; 88(6): 2479 - 2488. [Full Text] [PDF]

				W. L. Isley Growth Hormone Therapy for Adults: Not Ready for Prime Time? Ann Intern Med, August 6, 2002; 137(3): 190 - 196. [Abstract] [Full Text] [PDF]

				T. Kearney, C. Navas de Gallegos, A. Chrisoulidou, R. Gray, P. Bannister, S. Venkatesan, and D. G. Johnston Hypopituitarsim Is Associated with Triglyceride Enrichment of Very Low-Density Lipoprotein J. Clin. Endocrinol. Metab., August 1, 2001; 86(8): 3900 - 3906. [Abstract] [Full Text] [PDF]

				Effect of Growth Hormone (GH) Therapy on Endothelial Function in GH-Deficient Adults J. Clin. Endocrinol. Metab., December 1, 1999; 84(12): 4749b - 4750. [Full Text]

				M. Christopher, F. L. Hew, M. Oakley, C. Rantzau, and F. Alford Defects of Insulin Action and Skeletal Muscle Glucose Metabolism in Growth Hormone-Deficient Adults Persist after 24 Months of Recombinant Human Growth Hormone Therapy J. Clin. Endocrinol. Metab., May 1, 1998; 83(5): 1668 - 1681. [Abstract] [Full Text]

				R. C. Cuneo, S. Judd, J. D. Wallace, D. Perry-Keene, H. Burger, S. Lim-Tio, B. Strauss, J. Stockigt, D. Topliss, F. Alford, et al. The Australian Multicenter Trial of Growth Hormone (GH) Treatment in GH-Deficient Adults J. Clin. Endocrinol. Metab., January 1, 1998; 83(1): 107 - 116. [Abstract] [Full Text]

				K. A. S. Al-Shoumer, K. H. Cox, C. L. Hughes, W. Richmond, and D. G. Johnston Fasting and Postprandial Lipid Abnormalities in Hypopituitary Women Receiving Conventional Replacement Therapy J. Clin. Endocrinol. Metab., August 1, 1997; 82(8): 2653 - 2659. [Abstract] [Full Text] [PDF]