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Submitted on March 21, 2004
Accepted on November 29, 2004
Endocrine Section, Dept. of Internal Medicine, University of Brescia, Italy
* To whom correspondence should be addressed. E-mail: a.giustina{at}libero.it.
Aim the this perspective article will be to briefly review the lessons we learnt from the study of GHD on the relationship between GH and the principal metabolic cardiovascular risk factors and to critically evaluate to partial involvement of "subclinical" or perhaps better "functional" GHD in the increase in cardiovascular risk which is observed in aging and obesity. The lesson that "organic" GHD has taught to us is that primary impairment in the GH/IGF-1 axis may lead to a high risk cardiovascular profile which is partially reversible during GH replacement. We think that there are interesting analogies between the cardiovascular risk profile of situation of "functional" GHD such as aging and obesity with those of "organic" GHD. It remains to be demonstrated that intervention with GH can ameliorate this risk profile in functional as it happens in organic GHD. Lacking of this demonstration may not necessarily imply that "functional" GHD is rather a consequence than a cause of this risk profile but may also be linked to dose finding or to dimension of the study sample as well as length of follow-up.
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