Background:Survivors of childhood brain cancer survivors (CBCS) have a higher risk of endothelial dysfunction and cardiovascular mortality. Recombinant human growth hormone (rhGH) replacement therapy may help reduce endothelial damage and the development of cardiovascular diseases (CVD). This study aimed to assess biochemical and biophysical endothelial function in CBCS with GH deficiency (GHD).Methods:CBCS who were at least two years post-treatment underwent clinical evaluation, including anthropometric measurements and metabolic assessments (adiponectin, blood clotting, and lipid profile). Endothelial function was evaluated using the estimation of the reactive hyperemia index (RHI) measured by the EndoPAT 2000. A value < 1.5 was considered pathologic. CBCS without GHD served as the control group.Results:The study included 60 participants: 12 controls (mean age 14 ± 4.7 years) and 48 CBCS with GHD (mean age 16.6 ± 4.9 years), 8 of whom were not receiving rhGH therapy. The cohort showed a high prevalence of abnormal RHI values. Although there were no significant differences in weight or body mass index between groups, those with GHD, especially those not on rhGH therapy, had a higher prevalence of an RHI < 1.5, lower pathological adiponectin levels and a disrupted lipid profile.Conclusions:CBCS exhibited altered RHI values consistent with early endothelial biophysical dysfunction. Among patients with GHD, this impairment was further associated with an adverse lipid profile and signs of adipose tissue dysfunction. Recombinant growth hormone replacement therapy may contribute to a partial improvement in biochemical indicators of endothelial function.
背景：儿童脑癌幸存者（CBCS）存在内皮功能障碍和心血管死亡风险增高的问题。重组人生长激素（rhGH）替代疗法可能有助于减轻内皮损伤并降低心血管疾病（CVD）的发生风险。本研究旨在评估伴有生长激素缺乏症（GHD）的CBCS患者的内皮功能生化与生物物理学指标。 方法：对完成治疗至少两年的CBCS患者进行临床评估，包括人体测量学指标和代谢评估（脂联素、凝血功能及血脂谱）。采用EndoPAT 2000设备测定反应性充血指数（RHI）评估内皮功能，RHI值<1.5被视为病理状态。以无GHD的CBCS患者作为对照组。 结果：研究共纳入60名参与者，包括12名对照组（平均年龄14±4.7岁）和48名伴GHD的CBCS患者（平均年龄16.6±4.9岁），其中8名未接受rhGH治疗。该队列显示异常RHI值发生率较高。尽管组间体重或体重指数无显著差异，但GHD患者（特别是未接受rhGH治疗者）的RHI<1.5发生率更高，病理状态脂联素水平更低，且血脂谱紊乱。 结论：CBCS患者表现出RHI值改变，符合早期内皮生物物理学功能障碍特征。在GHD患者中，这种功能障碍进一步与不良血脂谱及脂肪组织功能障碍标志物相关。重组生长激素替代疗法可能部分改善内皮功能的生化指标。
The Impact of Growth Hormone Deficiency on Endothelial Function in Childhood Brain Cancer Survivors
肿瘤(癌症)患者之家