This protocol will assess the cardiovascular risk associated with growth hormone deficiency in adults. We will use multiple modalities to assess risk for heart attacks or strokes including blood work, ultrasound, MRI and endothelial cell biopsies in both patients who are growth hormone deficient and in patients with normal growth hormone secretion. We hypothesize that adults with growth hormone deficiency will have results suggestive of an increased risk for cardiovascular disease.
Subjects will first be tested for possible growth hormone deficiency. This will be done by administering two intravenous medications that should stimulate growth hormone secretion and we will measure growth hormone in the blood every 30 minutes following the administration. Once we have the results on enough subjects we will split the cohort into those subjects who are growth hormone deficient and those who have normal growth hormone. The two groups will each undergo various tests all designed to assess some component of cardiovascular risk. Ultimately we will compare the results of each test to see if those who are growth hormone deficient have an increased risk for cardiovascular disease.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
7
Subjects will have serum cardiovascular markers assessed
Subjects will receive GHRH and arginine intravenously and then have blood drawn at frequent intervals over a 90 minutes to assess growth hormone secretion.
Subjects will have an ultrasound of their neck to assess their carotid arteries to look for intima-medial thickness.
Columbia University, College of Physicians and Surgeons
New York, New York, United States
C-reactive Protein (CRP) Levels
C-reactive protein (CRP) levels in GH sufficient and GH deficient participants
Time frame: Day 1
Homocysteine Level
Homocytsteine levels in GH sufficient and GH deficient participants
Time frame: Day 1
Total Cholesterol Level
Total cholesterol levels in GH sufficient and GH deficient participants
Time frame: Day 1
Percentage of Fat Measured by DXA DEXA
Percentage of total body fat and trunk fat as measured by DXA
Time frame: Day 1
Lean Body Mass by DXA DEXA
Lean body mass as measured by DXA
Time frame: Day 1
Insulin Sensitivity as Assessed by Fasting Insulin Levels
Insulin sensitivity as assessed by fasting insulin levels
Time frame: Day 1
Glucose Levels as Assessed by an Oral Glucose Tolerance Test
Glucose levels as assessed by an oral glucose tolerance test
Time frame: Day 1
Endothelial Function as Assessed by Flow Mediated Dilatation and Endothelial Cell Biopsy
Endothelial function as assessed by flow mediated dilatation and endothelial cell biopsy for measurement of inflammatory markers.
Time frame: Day 1
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Subjects will have MRI and MR spectroscopy of the abdomen and lower extremities to assess for fat in internal organs and muscle.
Subjects will undergo endothelial cell biopsies to harvest endothelial cells to study. It will occur once and takes approximately 20 minutes. Patients will have an iv placed and then a sterile wire is passed back and forth in the iv a couple of times. Three wires are passed.
Carotid Intimal-medial Thickness Studies as Assessed by Ultrasound
Carotid intimal-medial thickness studies will be measured by ultrasound
Time frame: Year 1
Intramyocellular Lipid Content Using MRI and MR Spectroscopy
Intramyocellular lipid content using MRI and MR spectroscopy of the soleus muscle was performed.
Time frame: Day 1
Intrahepatic Lipid Content Using MRI and MR Spectroscopy
Intrahepatic lipid (IHL) content using MRI and MR spectroscopy of the liver was performed.
Time frame: Day 1