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A Follow-up Study of Vascular Disease in Growth-Hormone-Deficient Dwarfs with Diabetes

List of authors.
  • Thomas J. Merimee, M.D.

Abstract

Thirty - one growth - hormone - deficient dwarfs were re-examined after a period of 10 to 12 years. These subjects had initially shown glucose intolerance, insulinopenia and hyperlipidemia comparable to those of diabetic patients matched for age and sex, but vascular complications were not present in dwarfs.

After 10 years glucose tolerance became progressively more abnormal in dwarfs than could be accounted for by expected deterioration with age, and hyperglycemia after mixed meals remained greater than in control subjects. Serum lipid and serum lipoprotein concentrations were abnormal in over one third of the dwarfs.

Despite the metabolic similarity to the diabetic patients, clinical complications of diabetes were absent in dwarfs: retinopathy did not occur, and the prevalence of hypertension and arteriosclerosis was considerably lower in dwarfs than in the diabetic subjects in both study periods.

The follow-up data support the hypothesis that growth hormone has at least a supportive role in the pathogenesis of vascular disease in the diabetic state. (N Engl J Med 298:1217–1222, 1978)

Funding and Disclosures

Supported by a grant (HL-19175) from the National Heart, Lung, and Blood Institute, by a grant (AM-18130) from the National Institute of Arthritis, Metabolism and Digestive Diseases and by a grant from the Florida Citrus Commission.

I am indebted to Dr. Victor McKusick and the members of his Division at Johns Hopkins for their help in initiating and sustaining these studies from 1963 through 1968, to D. Turner, W. Albaugh and other members of the Little People of America organization, for help in conducting the follow-up studies, and to the many members of that organization who sacrificed their time at regional and national meetings to take part in these studies.

Author Affiliations

From the Division of Endocrinology and Metabolism, Department of Medicine, University of Florida School of Medicine (address reprint requests to Dr. Merimee at Box J-226, J. Hillis Miller Health Center, Gainesville, FL 32610).

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