Lipid patterns in treated growth hormone deficient children vs. short stature controls.

Abstract

Previous studies in adults with growth hormone (GH) deficiency have substantiated an increased risk of cardiovascular events. This risk has been attributed to an unpropitious lipid profile, increased abdominal mass, and higher incidence of metabolic syndrome. In these studies, a collateral observation has been a negative correlation between IGF-1 levels and lipid profiles. Longitudinal studies are lacking in children with GH-deficiency wherein the various lipid subfractions after GH treatment were compared to matched GH-sufficient short stature controls. Our study examined changes in small lipid particles following GH treatment. The primary objective was to determine the effect of GH treatment on serum lipids in GH-deficient patients vs. short controls. This was a prospective, unblinded, case-controlled, 6-month trial conducted at a tertiary pediatric referral center. Patients were referred for short stature. Incorporating accepted criteria, the treatment group (n=18) was found to be GH-deficient, whereas the control group (n=13) was GH-sufficient. The two groups had near-identical short stature along in addition to baseline measurements of weight and BMI. The treatment arm received 6 months of recombinant GH at standard doses. The primary endpoint was the comparison of the lipoprotein subclasses and lipids between the two groups after 6 months. With the exception of the intermediate density lipoprotein (IDL), there were no significant differences at baseline in serum lipid profiles between the GH-deficient children and the controls. After 6 months of therapy, there were statistically significant differences in Apo-B, LDL, and smaller lipoparticles (LDL-3 and non-HDL) in GH-treated children compared to untreated GH-sufficient short children. Our findings indicate that GH replacement may improve cardiovascular outcome by favorably altering lipid profiles.