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Published on: October 12, 2017
ApoE4 Determines the Reduction in LDL-C After GH Replacement Therapy in Children With an Idiopathic GH Deficiency
Hironori Nagasaka1, Satoshi Hirayama1, Mayuko Takuwa1
1Department of Pediatrics (H.N., M.T., M.N.), Takarazuka City Hospital, Hyogo 665-0827, Japan; Department of Clinical Laboratory Medicine (S.H., T.M.), Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan; Department of Pediatric Endocrinology and Metabolism (T.Y.), Children's Medical Center, Osaka City General Hospital, Osaka 534-0021, Japan; and Department of Pediatrics (H.K.), Nara Hospital, Kinki University Faculty of Medicine, Nara 630-0293, Japan.
Context:
GH activates the expression of low-density lipoprotein (LDL) receptors, leading to decreased LDL-cholesterol (LDL-C). Apolipoprotein (apo) E4 carriers suppress LDL receptor expression, rendering high LDL-C concentrations.
Objectives:
We examined whether GH-deficient children carrying apoE4 exhibited a greater reduction in LDL-C after GH replacement therapy.
Design And Setting:
We determined lipoprotein profiles after 0, 4, and 12 months of GH treatment in children with an idiopathic GH deficiency. We compared the effects of GH treatment on LDL-C by apoE phenotype.
Subjects:
In total, 66 children with idiopathic GH deficiency and 89 healthy children were classified into subgroups according to apoE phenotype.
Intervention:
The intervention included GH replacement therapy for 12 months.
Main Outcome Measures:
The relationship between apoE phenotype and reduced LDL-C induced by GH treatment was measured.
Results:
Concentrations of LDL-C and apoB were highest in the apoE4/3 group (n = 13), second highest in the apoE3/3 group (n = 46), and lowest in the apoE3/2 group (n = 7), whereas apoE concentrations were highest in the apoE3/2 group and lowest in the apoE4/3 group. The apoE4/3 group had significantly reduced LDL-C and apoB concentrations at months 4 and 12, whereas the apoE3/3 and apoE3/2 groups showed no changes. LDL-C concentrations did not differ among the three groups after 12 months. The trend in apoE concentration did not change among the groups.
Conclusions:
Children with a GH deficiency carrying apoE4 had higher baseline LDL-C concentrations and experienced a greater reduction in LDL-C after GH replacement therapy than those without apoE4.
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