Relação cortisol ∕cortisona na deficiência isolada do hormônio do crescimento

Abstract

Objective: to evaluate serum cortisol (F) and cortisone (E) and cortisol/cortisone ratio in subjects with isolated GH deficiency (IGHD) by mutation in the GHRH receptor (GHRH-R). Materials and Methods: transversal analytical study that evaluated 23 adults with IGHD homozygous mutation in the GHRH-R and compared to 21 normal homozygotes matched by age, sex and BMI through serum cortisol, cortisone, IGF1, total cholesterol, LDL-C, HDL-C and BMI and waist-hip ratio (W/H) measurements. Results: serum cortisol and F/E ratio presented at levels significantly higher in the IGHD group (p = 0.014 and 0.027, respectively). We found an increase of the W/H ratio in the affected subjects (p <0.0001) and positive correlation with this ratio with serum cortisol and F/E ratio (p = 0.01 and 0.029, respectively), but these didn´t correlate with BMI. The total cholesterol levels showed a trend to higher values in the group with IGHD, but LDL-C and HDL-C showed no statistically significant difference between groups. Conclusion: subjects with IGHD present higher cortisol and F/E ratio, which may reflect increased activity of the 11ß-hydroxysteroid dehydrogenase type 1 enzyme and contribute to the W/H ratio increase found in these patients. These hormonal, biochemical and body composition changes are known factors associated with insulin resistance and cardiovascular risk, outcomes not found in this population, remains a paradox in this model of GHD.