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Updated: Jul 27, 2025
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Vascular Function and Intima-Media Thickness in Children and Adolescents with Growth Hormone Deficiency: Results from
Nicola Improda1,2, Cristina Moracas3, Giuseppina Mattace Raso4
1Paediatric Endocrinology Unit, Department of Translational Medical Sciences, "Federico II" University, Naples, Italy.
Insights
Children with growth hormone deficiency (GHD) show early signs of atherosclerosis, including endothelial dysfunction and altered lipid profiles. Growth hormone (GH) treatment effectively reverses these markers, improving vascular health.
Area of Science:
- Pediatric Endocrinology
- Cardiovascular Research
- Metabolic Disorders
Background:
- Growth hormone deficiency (GHD) is linked to potential cardiovascular issues.
- Existing data on vascular health in GHD children is limited and inconsistent.
- This study investigates GHD's impact on endothelial function and vascular structure.
Purpose of the Study:
- To assess endothelial function and intima-media thickness (IMT) in children with GHD.
- To determine the effects of growth hormone (GH) treatment on these vascular parameters.
- To identify early atherosclerotic markers in GHD pediatric patients.
Main Methods:
- Compared 24 GHD children with 24 age-, sex-, and BMI-matched controls.
- Measured anthropometry, lipid profile, asymmetric dimethylarginine (ADMA), brachial flow-mediated dilatation (FMD), and carotid intima-media thickness (cIMT, iIMT).
- Re-evaluated GHD children after 12 months of GH therapy.
Main Results:
- GHD children had higher cholesterol, LDL, atherogenic index (AI), ADMA, and waist-to-height ratio (WHtR) at baseline.
- GH treatment reduced WHtR, cholesterol, LDL, AI, and ADMA.
- Endothelial function (FMD) was impaired in GHD children but improved with GH treatment; IMT showed slight reductions post-treatment.
Conclusions:
- GHD in children is associated with endothelial dysfunction and early atherosclerotic indicators.
- These include visceral adiposity and dyslipidemia.
- Growth hormone treatment effectively restores vascular function and improves these markers.
Introduction:
Growth hormone deficiency (GHD) may be associated with subtle cardiovascular abnormalities, reversible upon starting GH treatment. Data on vascular morphology and function in GHD children are scanty and inconclusive. The aim of our study was to evaluate the effects of GHD and GH treatment on endothelial function and intima-media thickness (IMT) in children and adolescents.
Methods:
We enrolled 24 children with GHD (10.85 ± 2.71 years) and 24 age-, sex-, and BMI-matched controls. We evaluated anthropometry, lipid profile, asymmetric dimethylarginine (ADMA), brachial flow-mediated dilatation (FMD), and IMT of common (cIMT) and internal (iIMT) carotid artery at study entry in all subjects and after 12 months of treatment in GHD children.
Results:
At baseline GHD, children had higher total cholesterol (163.17 ± 18.66 vs. 149.83 ± 20.68 mg/dL, p = 0.03), LDL cholesterol (91.18 ± 20.41 vs. 77.08 ± 19.73 mg/dL, p = 0.019), atherogenic index (AI) (2.94 ± 0.71 vs. 2.56 ± 0.4, p = 0.028), and ADMA (215.87 ± 109.15 vs. 164.10 ± 49.15 ng/mL, p < 0.001), compared to controls. GHD patients also exhibited increased higher waist-to-height ratio (WHtR) compared to controls (0.48 ± 0.05 vs. 0.45 ± 0.02 cm, p = 0.03). GH therapy resulted in a decrease in WHtR (0.44 ± 0.03 cm, p = 0.001), total (151.60 ± 15.23 mg/dL, p = 0.001) and LDL cholesterol (69.94 ± 14.40 mg/dL, p < 0.0001), AI (2.28 ± 0.35, p = 0.001), and ADMA (148.47 ± 102.43 ng/mL, p < 0.0001). GHD showed lower baseline FMD than controls (8.75 ± 2.44 vs. 11.85 ± 5.98%, p = 0.001), which improved after 1-year GH treatment (10.60 ± 1.69%, p = 0.001). Baseline cIMT and iIMT were comparable between the two groups, but slightly reduced in GHD patients after treatment.
Conclusion:
GHD children may exhibit endothelial dysfunction in addition to other early atherosclerotic markers like visceral adiposity, and altered lipids, which can be restored by GH treatment.
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