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Carotid Intima-Media Thickness in Children Treated with Growth Hormone: A Follow-Up Study over Three Years
Juliane Rothermel1, Caroline Knop, Nina Lass
1Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany.
Insights
High doses of growth hormone (GH) treatment did not show significant changes in carotid intima-media thickness (cIMT), a marker for atherosclerosis. Further research is needed on insulin-like growth factor (IGF) impacts.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Health
- Growth Hormone Therapy
Background:
- Cardiovascular disease risk associated with high-dose growth hormone (GH) therapy is debated.
- Carotid intima-media thickness (cIMT) is a key indicator of atherosclerosis and cardiovascular risk.
Purpose of the Study:
- To investigate the longitudinal relationship between growth hormone (GH) treatment and carotid intima-media thickness (cIMT) in children.
- To assess whether supraphysiological GH doses impact cIMT compared to physiological doses in GH deficiency (GHD).
Main Methods:
- A 3-year longitudinal study comparing 28 children on supraphysiological GH doses with 36 children with GHD on physiological GH doses.
- Measurements included blood pressure, lipids, HbA1c, IGF-1, IGFBP-3, and cIMT.
- Analysis correlated these parameters with cIMT changes over time.
Main Results:
- No significant changes in cIMT were observed in children with GHD.
- A significant increase in mean cIMT was noted in children receiving supraphysiological GH doses (p=0.049).
- IGF-1, IGFBP-3, BMI SDS, and treatment duration correlated with cIMT, while blood pressure, lipids, and HbA1c did not.
Conclusions:
- No definitive evidence links GH treatment to significant cIMT changes.
- Further investigation into the roles of IGF-1 and IGFBP-3 in modulating cIMT is warranted.
Background:
There is an ongoing discussion whether high doses of growth hormone (GH) may lead to cardiovascular diseases. Therefore, we studied the longitudinal relationships between GH treatment and carotid intima-media thickness (cIMT), which is predictive of the development of atherosclerosis.
Methods:
We measured blood pressure, lipids, hemoglobin HbA1c, IGF-1, IGFBP-3, and cIMT in 28 children treated with supraphysiological doses of GH (mean age 9.8 ± 2.2 years, 39% males) and 36 children suffering from GH deficiency (GHD) and treated with physiological doses of GH (mean age 9.7 ± 2.2 years, 72% males) in a longitudinal study over 3 years.
Results:
The cIMT values did not change significantly in the observation period in children with GHD (Δmaximum and Δmean cIMT 0.0 ± 0.1 mm). The mean (+0.1 ± 0.1 mm) but not the maximum cIMT (0.0 ± 0.1 mm) increased significantly (p = 0.049) in the children treated with supraphysiological doses of GH. Blood pressure, lipids, and HbA1c were not related to cIMT, while IGF-1, IGFBP-3, body mass index expressed as a standard deviation score, and treatment duration correlated significantly with cIMT.
Conclusions:
We did not find any robust evidence that GH treatment is associated with changes in cIMT. Further studies are necessary to analyze the impact of IGF-1 and IGFBP-3 concentrations on cIMT.
