Endocrine Abstracts

Growth hormone deficiency (GHD) is associated with adverse changes in lipid profile. There are no longitudinal studies of lipid abnormalities in childhood-onset GHD into adulthood. In order to more accurately define the metabolic consequences of GHD in childhood progressing through to adulthood we have examined lipid levels in a group of untreated severely GHD patients with a mutation in the GHRH receptor gene from a rural community in Northeast Brazil.

15 GHD subjects (8 children and adolescents (1 male), age 13.2 (5.4-19.9) years; 7 adults (1male), age 47 (33-66) years) were compared with 29 indigenous controls (17 children & adolescents (6 male), age 10.2 (5.3-18.4) years; 12 adults (8 male), age 54.5 (33-80) years). All GHD subjects had a peak GH response of <0.5 ng/ml to an insulin tolerance test and extremely abnormal IGF1 levels of 5.5 (0-14.5)ng/ml. Data are presented as median (range) and statistical analysis uses non parametric tests.

Plasma total cholesterol (TC) and LDL-cholesterol (LDL-C) levels were higher in the GHD adults than controls (p<0.05) (6.3 vs 4.1; 4.3 vs 2.6 respectively) but not between sex- and age-matched GHD children and controls. However when the plasma lipid levels of GHD and normal control children were compared with reference ranges (5-95th percentile) for an sex- and age-matched white population more GHD children had levels of plasma TC and LDL-C above the 95th percentile (3/8; 4/7 respectively) compared with controls (0/17; 1/15) (p<0.05). No significant difference was seen in HDL-cholesterol (HDL-C), total cholesterol/HDL-cholesterol ratio (TC/HDL-C) or triglyceride levels in the children or adult cohorts.

The lipid profile in children as well as in adults with very severe GHD is adversely modified. With our limited numbers there appears to be no significant worsening of the lipid abnormality with duration of GHD or achievement of adulthood.