Bollerslev J et al. (2006) Positive effects of a physiological dose of GH on markers of atherogenesis: a placebo-controlled study in patients with adult-onset GH deficiency. Eur J Endocrinol 154: 537–543

Patients with growth hormone deficiency (GHD) have an increased risk of obesity, insulin resistance, lipid alterations, atherosclerotic changes, and also have reduced cardiac performance, all of which increase morbidity and mortality. In a placebo-controlled, double-blind, crossover study, Bollerslev et al. investigated the effects of GH therapy on cardiovascular risk factors in patients with GHD.

A total of 55 patients with severe, adult-onset GHD of at least 2 years' duration underwent consecutive 9-month periods of treatment with recombinant human GH therapy (Genotropin®, Pfizer, New York, NY, USA) and placebo. There was a 4-month washout period in between treatments. The dose of GH therapy given to each patient was individually titrated to maintain levels of serum insulin-like growth factor 1 to within the normal range. Women were given a 50% higher mean dose of GH therapy than men, such that similar levels of serum insulin-like growth factor 1 were reached in both sexes. GH therapy decreased serum C-reactive protein by 41% and improved levels of apolipoprotein B cholesterol compared with placebo. There was no effect on levels of apolipoprotein A-1 and interleukin-6 in patients throughout the study period.

The authors conclude that, in treatment-naive patients with adult-onset GHD, GH-replacement therapy has a positive effect on cardiovascular risk, mediated by decreased levels of both apolipoprotein B and C-reactive protein. These factors are markers of atherogenesis and subclinical inflammation, respectively.