This Article Full Text Full Text (PDF) All Versions of this Article: 91/5/1872    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Follin, C. Articles by Erfurth, E. M. Search for Related Content PubMed PubMed Citation Articles by Follin, C. Articles by Erfurth, E. M. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Metabolic Syndrome Related Collections Cardiovascular Endocrinology Metabolism Neuroendocrinology and Pituitary

Improvement in Cardiac Systolic Function and Reduced Prevalence of Metabolic Syndrome after Two Years of Growth Hormone (GH) Treatment in GH-Deficient Adult Survivors of Childhood-Onset Acute Lymphoblastic Leukemia

Departments of Endocrinology (C.F., B.A., E.M.E.) and Cardiology (U.T.), Lund University Hospital, SE 221 85 Lund, Sweden

Address all correspondence and requests for reprints to: Eva Marie Erfurth, Department of Endocrinology, Lund University Hospital, SE-221 85 Lund, Sweden. E-mail: eva_marie.erfurth{at}med.lu.se.

Context: Survivors of childhood-onset (CO) acute lymphoblastic leukemia (ALL) treated with prophylactic cranial radiotherapy often exhibit GH deficiency (GHD), which is associated with increased prevalence of cardiovascular risk factors and cardiac dysfunction.

Objective: The objective of the study was to evaluate the effect of GH replacement on cardiovascular risk factors and cardiac function in former CO ALL patients.

Design: Eighteen former CO ALL patients (aged 19–32 yr) treated with cranial radiotherapy (18–24 Gy) and chemotherapy and with confirmed GHD were studied at baseline and after 12 (n = 18) and 24 months (n = 13) of GH treatment (median 0.5 mg/d). A group of 18 age- and sex-matched subjects served as controls.

Results: After 12 months of GH treatment, a significant decrease in serum leptin (P = 0.002), leptin per kilogram fat mass (FM) (P = 0.01), plasma glucose (P = 0.004), FM (P = 0.002), and hip (P = 0.04) and waist (P = 0.02) circumference and increased muscle mass (P = 0.004) were recorded in the patients. Before GH treatment six patients had a metabolic syndrome, but after 12 months only one had it and after 24 months none. After 24 months of GH treatment, an increase in left ventricular mass index (P = 0.06) and significant improvements in cardiac systolic function, measured as fractional shortening (P = 0.03) and ejection fraction (P = 0.03), were recorded.

Conclusions: Improvement in cardiac systolic function and reduced prevalence of metabolic syndrome were recorded after 2 yr of GH replacement in former CO ALL patients with GHD. Long-term follow-up is highly warranted.