Endocrine Abstracts

Background: Endothelial dysfunction is considered an early step in the development of atherosclerosis, while an increased intima-media thickness (IMT) represents one of the earliest morphological changes in the arterial wall in the process of atherogenesis. Only a few studies have investigated endothelial dysfunction and IMT in GHD children and results are still inconsistent.

Objective: Aim of our study was to evaluate the effects of GHD and GH treatment on endothelial function and IMT in childhood.

Methods: 24 GHD children (10.8±2.7 years) and 24 age-, sex- and BMI-matched controls were enrolled into the study. At baseline all subjects underwent auxological and anthropometric measurements, evaluation of lipid profile [triglycerides, total-, LDL-, HDL cholesterol, atherogenic index (AI = total/HDL cholesterol), non HDL cholesterol (total cholesterol – HDL cholesterol)], evaluation of endothelial function by ultrasound assessment of brachial flow-mediated dilatation (FMD) and IMT of common carotid artery (cIMT) and of internal carotid artery (iIMT). These evaluations were repeated after 12 months of GH treatment in GHD children.

Results: At baseline GHD children had higher total cholesterol (162.83±18.33 vs 149.83±20.63 mg/dl, P=0.04), LDL cholesterol (91.48±21.73 vs 77.08±19.73 mg/dl, P=0.02), non HDL cholesterol (102.4±20.23 vs 89.33±18.03 mg/dl, P=0.04) and AI (2.84±0.5 vs 2.56±0.4, P=0.03) compared with controls. No differences were found in triglycerides and HDL cholesterol between patients and controls. GH therapy was associated with a significant reduction in total- (151.42±14.90 mg/dl, P=0.03), LDL- (74.44±15.56 mg/dl, P=0.005), non HDL cholesterol (86.42±17.81 mg/dl, P=0.01) and AI (2.29±0.35, P=0.0001), while triglycerides and HDL cholesterol did not change. Moreover, at study entry GHD children showed lower values of FMD (8.75±2.44 vs 11.85±5.98%; P=0.02) compared to controls while no difference was found in cIMT (0.37±0.08 vs 0.40±0.06 mm) and iIMT (0.33±0.06 vs 0.36±0.07 mm). GH treatment was associated to a significant improvement in FMD (10.60±1.69%, P=0.04). cIMT and iIMT slightly reduced in patients after 12 months of GH treatment although these differences did not reach statistical significance. No correlations were found between changes in FMD and total-, LDL-, non HDL cholesterol and AI.

Conclusions: Our results suggest that GHD children may exhibit subtle lipid alterations and early markers of atherosclerosis as documented by negative changes in FMD values. GH exerts beneficial effects restoring endothelial function and abnormalities in lipid profile.