title: 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: BACKGROUND
  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.
  
  
  METHODS
  This was a 2-yr case-control prospective study.
  
  
  METHODS
  Thirty children with GHD aged 9.3 +/- 0.5 yr and 30 healthy matched controls were studied.
  
  
  METHODS
  Children were studied before and after 1 and 2 yr of GH replacement (GHD children) or no treatment (controls).
  
  
  METHODS
  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.affiliation: Department of Pediatrics, Federico II University of Naples, Via S. Pansini 5, 80131 Naples, Italy. salerno@unina.it
authors.forename: Mariacarolina
authors.initials: M
authors.lastname: Salerno
authors.forename: Valentina
authors.initials: V
authors.lastname: Esposito
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Farina
authors.forename: Giorgio
authors.initials: G
authors.lastname: Radetti
authors.forename: Angela
authors.initials: A
authors.lastname: Umbaldo
authors.forename: Donatella
authors.initials: D
authors.lastname: Capalbo
authors.forename: Letizia
authors.initials: L
authors.lastname: Spinelli
authors.forename: Stefania
authors.initials: S
authors.lastname: Muzzica
authors.forename: Gaetano
authors.initials: G
authors.lastname: Lombardi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D016022:Case-Control Studies; D002648:Child; D004452:Echocardiography; D005260:Female; D013006:Growth Hormone / Q000627:therapeutic use*; D006321:Heart / Q000033:anatomy & histology / Q000187:drug effects*; D006334:Heart Function Tests; D019382:Human Growth Hormone / Q000097:blood / Q000172:deficiency*; D006801:Humans; D050356:Lipid Metabolism; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D019382:Human Growth Hormone; D013006:Growth Hormone