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Recombinant human GH replacement increases CD34+ cells and improves endothelial function in adults with GH deficiency

¹ Department of Endocrinology and Metabolic Diseases, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands² Department of Nephrology, Leiden University Medical Center, Leiden, The Netherlands

(Correspondence should be addressed to A A van der Klaauw; Email: a.a.van_der_klaauw{at}lumc.nl)

Objective: Adult patients with GH deficiency (GHD) are at increased risk for cardiovascular morbidity and mortality. Endothelial function, vascular stiffness, and loss of circulating CD34+ cells are considered biomarkers for cardiovascular disease. The aim of this study was to assess vascular structure and function in relation to circulating CD34+ cells in adults with GHD before and during 1 year of recombinant human GH (rhGH) replacement.

Design: One-year intervention with rhGH.

Patients and methods: Vascular function (flow-mediated dilatation (FMD)) and structure (pulse wave velocity (PWV) and analysis) were assessed in 14 adult patients (nine men) with GHD (mean age 57 years, range 27–71 years). In addition, the number of CD34+ cells was evaluated using flow cytometric analysis. Study parameters were analyzed at baseline, and after 6 months and 1 year of rhGH replacement.

Results: rhGH replacement increased IGF-I levels from 10.4±4.5 mmol/l at baseline to 18.4±10.1 mmol/l, and 20.5±8.0 mmol/l, at 6 months, and 1 year respectively (P=0.001). FMD increased from 3.5±1.8% to 6.0±2.5% and 5.1±2.5% during 1 year of rhGH replacement (P=0.008). There was no beneficial effect on PWV, central pulse pressure, central systolic pressure, and augmentation index. The number of CD34+ cells increased from 794.9±798.8 to 1270.7±580.1 cells/ml and to 1356.9±759.0 cells/ml (P=0.010).

Conclusion: One year of rhGH replacement in adults with GHD improves endothelial function and increases the number of circulating CD34+ cells.