Circulating asymmetric dimethylarginine and lipid profile in pre-pubertal children with growth hormone deficiency: Effect of 12-month growth hormone replacement therapy

ObjectiveGrowth hormone deficiency (GHD) in adults is associated with cardiovascular complications, which lead to reduced life expectancy. At present, data on cardiovascular risk factors in GHD children are limited. The aim of this study was to evaluate whether pre-pubertal GHD children have increased cardiovascular risk factors, and whether 12-month growth hormone (GH) treatment can reverse them.DesignTwenty pre-pubertal GHD children (6 boys, mean (± SD) age: 9.5 ± 1.8 years) were matched for sex and age with 20 healthy controls (6 boys, mean (± SD) age: 8.8 ± 1.5 years). Asymmetric dimethylarginine (ADMA), lipid profile, glucose metabolism parameters, IGF-1, blood pressure and anthropometric parameters were assessed at baseline and after 12 months of GH treatment.ResultsAt baseline, GHD patients showed significantly higher ADMA levels (median [interquartile range]: 78.5 [69.6–123.5] vs 54.0 [38.3–60.8] ng/ml, p < 0.001), total cholesterol (mean ± SD: 177.5 ± 30.4 vs 150.1 ± 21.4 mg/dl; p = 0.004) and LDL-cholesterol (mean ± SD: 111.2 ± 22.2 vs 84.9 ± 15.9 mg/dl; p < 0.001) than controls. After 12-month GH treatment, ADMA (median [interquartile range]: 55.4 [51.2–73.8] ng/ml), total cholesterol (mean ± SD: 155.6 ± 43.2 mg/dl), and LDL-cholesterol (mean ± SD: 95.4 ± 32.1 mg/dl) significantly decreased in GHD children, reaching values comparable to those in controls.ConclusionsThis study showed that, as in adults, pre-pubertal GHD children manifest increased cardiovascular risk markers and that 12-month GH treatment can improve them.