Vascular Disease in the Chronic HGH-deficient State

Twenty-four of thirty-one subjects with human growth hormone (HCH) deficiency but otherwise normal pituitary function were studied over a five year period. Metabolic abnormalities in this group included carbohydrate intolerance, with both increased and decreased insulin secretion, hypertriglyceridemia and hypercholesterolemia. Approximately 50 per cent of the total group manifested a type Ha or lib lipoprotein abnormality. We established previously that despite these metabolic similarities to subjects with diabetes mellitus, the HGHdeficient subjects did not develop diabetic retinopathy or increased thickness of muscle capillary basement membranes. During the past five years, we have gathered objective data regarding involvement of larger arterial vessels in these patients and in age- and sex-matched diabetics and controls. Whereas 12.5 per cent of the dwarfs and 18.5 per cent of the controls consistently exhibited hypertension (> 150/90), 36 per cent of the diabetics were consistently hypertensive. Only one of twenty-four dwarfs followed for five years evidenced coronary artery or peripheral vascular disease, as indicated by studies including electrocardiograms in basal and stress states; 40 per cent of the diabetics and 5.2 per cent of the controls had findings indicating such disease. The data would be consistent with an hypothesis that a chronic deficiency of HGH deters the development of both microangiopathic and macroangiopathic pathologic changes to a clinically detectable state. The protective effect may result from an inability of protein synthesis to proceed at normal rates when HCH is absent.