Cardiovascular features in adults with PWS

In this paper, the authors looked at cardiovascular structure/function in adults with PWS compared to adults with simple obesity. They were interested in better defining whether/why adults with PWS have detectable and/or different heart problems.

They want to better understand why people with PWS may develop heart problems as adults (are there other factors, aside from obesity, that decrease cardiovascular function in adults with PWS?). An important to note here: the average age of the individuals is 26 and it's not stated whether the individuals have had any growth hormone therapy.

Basically they found that
-despite obesity, people with PWS have a better than expected metabolic profile (eg, good trigylcerides) - this is consistent with previous reports
-compared to simple obesity, people with PWS have more breathing problems during sleep (apnea, low oxygen) than those with simple obesity. This is important because apnea increases the risk for heart disease. (it may be that frequent episodes of low oxygen/high carbon dioxide during sleep is a problem that may need more attention/treatment in PWS)
-the size of the left ventricle of the heart may be lower (I say 'may be' because if they measure according to weight, it is lower, if they measure according to height, it is not).
-people with PWS did not have as increased a heart rate upon stimulation as those with simple obesity (consistent with previous studies)
-several of the individuals with PWS had growth hormone deficiency (GHD) and GHD/hypopitutary is known to increase cardiovascular disease. The 'IGF-1' that they talk about is insulin-like growth factor-1, which is part of the GH axis.

After considering everything, they felt the cardiovascular features 'look like' what happens in GH deficient patients (who don't have PWS). Thus, they think GHD is likely to be an important cause of card iovascular problems in PWS. The good news here is that it suggests that growth hormone therapy in adults might be beneficial in this respect (remains to be evaluated).

The impact of GH/IGF-I axis and nocturnal breathing disorders on cardiovascular features of adult patients with Prader-Willi Syndrome. Marzullo P, Marcassa C, Campini R, Eleuteri E, Minocci A, Priano L, Temporelli P, Sartorio A, Vettor R, Liuzzi A, Grugni G. J Clin Endocrinol Metab. 90: 5639 - 5646, 2005