CONTEXT: GH deficiency (GHD) in adults is associated with a cluster of cardiovascular risk factors that may contribute to an increased mortality for cardiovascular disease. OBJECTIVE: The aim of this study was to evaluate the effect of GHD and GH replacement therapy on cardiac performance, lipid profile, and insulin resistance in children. DESIGN: This was a 2-yr case-control prospective study. PATIENTS: Thirty children with GHD aged 9.3 +/- 0.5 yr and 30 healthy matched controls were studied. INTERVENTION: Children were studied before and after 1 and 2 yr of GH replacement (GHD children) or no treatment (controls). MAIN OUTCOME MEASURES: Lipid profile, serum insulin levels, homeostasis model of assessment (HOMA) index, and left ventricular (LV) mass and function by echocardiography were the main outcome measures. RESULTS: At study entry, the LV mass index was significantly lower in GHD children (50.2 +/- 1.7) than in controls (60.3 +/- 2.5 g/m(2); P < 0.002), whereas LV systolic and diastolic function, lipid profile, insulin levels, and HOMA index were similar. In GHD children LV mass index significantly increased (66.3 +/- 2.4 g/m(2); P < 0.0001) after 1 yr of GH replacement and remained stable thereafter. LV systolic and diastolic function did not change during treatment. After 2 yr of GH replacement, total cholesterol (P < 0.007) and the atherogenic index (P < 0.0001) significantly decreased, whereas fasting insulin levels (P < 0.001) and HOMA index (P < 0.0001) significantly increased compared with both pretreatment and control values. CONCLUSIONS: 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.
CONTEXT: GH deficiency (GHD) in adults is associated with a cluster of cardiovascular risk factors that may contribute to an increased mortality for cardiovascular disease. OBJECTIVE: The aim of this study was to evaluate the effect of GHD and GH replacement therapy on cardiac performance, lipid profile, and insulin resistance in children. DESIGN: This was a 2-yr case-control prospective study. PATIENTS: Thirty children with GHD aged 9.3 +/- 0.5 yr and 30 healthy matched controls were studied. INTERVENTION: Children were studied before and after 1 and 2 yr of GH replacement (GHD children) or no treatment (controls). MAIN OUTCOME MEASURES: Lipid profile, serum insulin levels, homeostasis model of assessment (HOMA) index, and left ventricular (LV) mass and function by echocardiography were the main outcome measures. RESULTS: At study entry, the LV mass index was significantly lower in GHD children (50.2 +/- 1.7) than in controls (60.3 +/- 2.5 g/m(2); P < 0.002), whereas LV systolic and diastolic function, lipid profile, insulin levels, and HOMA index were similar. In GHD children LV mass index significantly increased (66.3 +/- 2.4 g/m(2); P < 0.0001) after 1 yr of GH replacement and remained stable thereafter. LV systolic and diastolic function did not change during treatment. After 2 yr of GH replacement, total cholesterol (P < 0.007) and the atherogenic index (P < 0.0001) significantly decreased, whereas fasting insulin levels (P < 0.001) and HOMA index (P < 0.0001) significantly increased compared with both pretreatment and control values. CONCLUSIONS: 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.
Authors: Adda Grimberg; Kristen A Feemster; Susmita Pati; Mark Ramos; Robert Grundmeier; Andrew J Cucchiara; Virginia A Stallings Journal: Pediatrics Date: 2011-03-21 Impact factor: 7.124
Authors: Osman Ozdemir; Ayhan Abaci; Samil Hizli; Cem Hasan Razi; Ahmet Zulfikar Akelma; Mesut Kocak; Fatih Mehmet Kislal Journal: Pediatr Cardiol Date: 2011-04-07 Impact factor: 1.655
Authors: David C Landy; Tracie L Miller; Stuart R Lipsitz; Gabriela Lopez-Mitnik; Andrea S Hinkle; Louis S Constine; M Jacob Adams; Steven E Lipshultz Journal: Pediatr Cardiol Date: 2012-10-19 Impact factor: 1.655