Growth hormone resistance in acute myocardial infarction
Background and aim: Hormonal and immunological aspects of acute myocardial infarction (AMI) are in the past decade in focus of interest of researchers. We investigated concentrations of insulin like growth factor 1 (IGF-1), growth hormone (GH), insulin and markers of insulin resistance as like as inflammatory markers in order to find out their role and relationship in AMI.
Material and methods: A prospective study was performed at University Clinical Center Tuzla from January to October 2010. Study group was consisted of 75 patients with AMI. There were 30 healthy controls. Blood samples were taken within first 24 hours of admission and analyzed for GH, IGF-1 and insulin at the Department of Nuclear Medicine. Glucose, glycolised hemoglobin HbA1c, C-reactive protein (CRP), fibrinogen etc. were analyzed by standard methods at Biochemistry unit.
Results: Median of GH in the study group (0,96) was higher than in controls (0,26); p <0.001. Difference in median’s concentrations of IGF-1 between AMI and controls was also significant (123 vs. 132 respectively; p< 0,05) as like as IGF-1/GH ratio (p <0.001). Concentration of insulin was higher in study (9,5) than in control group (7,1), but without statistical significance. Despite this, we found out significant difference between concentrations of glucose, HOMA-IR and HbA1C among groups. Levels of CRP and fibrinogen were significantly higher in AMI. Simple linear correlation analysis showed positive correlation between GH and CRP (R 0,350255, p< 0,005).
Conclusions: GH resistance in AMI (Low IGF-1/GH) is probably result of inflammatory/immunological response and therefore could be prognostic marker.