Improvement of Cardiac Performance and Cardiovascular Risk Factors in Children with GH Deficiency after Two Years of GH Replacement Therapy: An Observational, Open, Prospective, Case-Control Study

Abstract

GHD in children is associated with a reduced cardiac size but with a normal cardiac function, lipid profile, and insulin sensitivity. Two years of GH replacement normalizes cardiac morphology, improves lipid profile, and slightly impairs insulin sensitivity.

Revaluation of the clinical and metabolic behavior of children with isolated growth hormone deficiency during GH treatment according to newly proposed note 39 of the Italian Medicines Agency (AIFA)

“…Indeed, particularly after the first 12 months of GH treatment, we found a worsening trend of insulin sensitivity, as documented by increase in fasting glucose and insulin levels, Homa-IR and HbA1c, in both groups of GHD children and this trend was greater in Group B. This finding is consistent with the data of Salerno et al which showed in children during GH treatment that the HOMA index increased more significantly in the group with partial than those with severe GHD [27]. In addition, the children of the Group A showed a decrease in LDL cholesterol during the first 12 months of treatment and higher HDL cholesterol than Group B throughout the follow-up.…”

Metabolic parameters and adipokine profile during GH replacement therapy in children with GH deficiency

“…Lanes et al (5) report increased LDL cholesterol levels in GHD adolescents when compared with healthy controls, whereas total HDL cholesterol and triglyceride concentrations were similar in the two groups; conversely, other authors have not reported any abnormalities in lipid profiles (22)(23)(24). In our study, at baseline, we found a significant difference in total and LDL cholesterol between GHD children and controls, with significantly higher levels in the first group, though still within the normal range.…”

Resistin, visfatin, leptin and omentin are differently related to hormonal and metabolic parameters in growth hormone-deficient children

“…Adipocytes secrete hormones known as adipokines, many of which regulate metabolism and influence insulin sensitivity and secretion [2]. Untreated GH deficiency (GHD) in children, as well as in adults, is associated with abnormalities in body composition, in addition to a cluster of cardiometabolic risk factors such as increased peripheral inflammatory markers and impairment in glucose and lipid metabolism, and GH treatment seems to exert beneficial effects on most of these alterations [3][4][5].…”