Increase of serum lipoprotein (a), an adverse effect of growth hormone treatment

Area of Science:

• Endocrinology
• Cardiovascular Medicine
• Metabolic Research

Background:

• Elevated endogenous or therapeutic human growth hormone (hGH) is linked to increased serum lipoprotein a (Lp(a)).
• Lipoprotein a (Lp(a)) is a thrombogenic factor and an independent risk marker for atherosclerotic cardiovascular disease (ASCVD).

Purpose of the Study:

• To investigate the hypothesis that growth hormone's effect on Lp(a) synthesis contributes to cardiovascular morbidity observed with hGH treatment.
• To evaluate the clinical utility of monitoring serum Lp(a) levels in patients undergoing hGH therapy.

Main Methods:

• Review of existing reports on hGH administration and serum Lp(a) levels.
• Analysis of the association between hGH treatment and cardiovascular outcomes.
• Proposal for prospective monitoring of Lp(a) in children and adults receiving hGH.

Main Results:

• Consistent reports indicate that high hGH levels correlate with increased serum Lp(a).
• The thrombogenic nature of Lp(a) positions it as a significant risk factor for ASCVD.
• A potential causal link between hGH, elevated Lp(a), and cardiovascular events is suggested.

Conclusions:

• The observed association between childhood hGH treatment and cardiovascular morbidity may be mediated by hGH-induced increases in Lp(a).
• Monitoring serum Lp(a) levels before and during hGH treatment is recommended for both pediatric and adult patients.
• This monitoring could aid in risk stratification and management of cardiovascular complications associated with hGH therapy.