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Lipids and apolipoproteins in growth hormone-deficient children during treatment
G B Schaefer1, N G Greger, J D Fesmire
1Department of Pediatrics, University of Nebraska Medical Center, Omaha.
Insights
Growth hormone (GH) influences lipid metabolism. GH deficiency in children is linked to hyperlipidemia, with therapy showing minor effects on lipid levels but increasing a marker of high triglycerides.
Area of Science:
- Endocrinology
- Metabolic Research
- Pediatric Lipidology
Background:
- The precise role of growth hormone (GH) in plasma lipoprotein regulation remains unclear.
- Previous research suggests a potential influence of GH on cholesterol levels.
Purpose of the Study:
- To assess alterations in lipid and apolipoprotein profiles in children with GH deficiency and neurosecretory dysfunction (NS) before and after GH therapy.
- To identify potential correlations between GH status and lipid abnormalities.
Main Methods:
- Longitudinal study evaluating 20 children with GH deficiency and 7 with NS.
- Analysis of lipid parameters, including total cholesterol (TC) and triglycerides (TG).
- Measurement of apolipoprotein (apo) C-III levels and its heparin-precipitated fraction (HP).
Main Results:
- GH-deficient children exhibited elevated mean TC and apo C-III levels; 28% were hyperlipidemic at baseline.
- NS group showed only one child with elevated TC; apo C-III HP was elevated in this group.
- GH therapy did not significantly alter TC or TG but increased apo C-III HP in GH-deficient children.
Conclusions:
- GH plays a role in modulating lipid metabolism, particularly in GH-deficient children.
- A subset of patients with GH deficiency and hypercholesterolemia was identified.
- GH replacement therapy had limited impact on overall lipid profiles in this cohort.
Abstract:
The role of growth hormone (GH) in regulating the transport of plasma lipoproteins has not been clearly defined, but past studies suggest that GH may influence cholesterol levels. This protocol was designed to evaluate possible changes in lipid and apolipoprotein status in GH-deficient children and children with neurosecretory dysfunction (NS) before GH therapy and at intervals after GH therapy was started. Twenty children with classic GH deficiency were evaluated, and 28% were hyperlipidemic at the onset of the study. Seven children were evaluated in the NS group, and only one (14%) showed an elevated total cholesterol (TC) greater than 200 mg/dL. The mean TC for all the GH-deficient children was elevated above the normal range, but not for the NS group. The mean apolipoprotein (apo) C-III level and its heparin-precipitated fraction (HP) were also elevated in the GH-deficient group, but only the apo C-III HP was elevated in the NS group. A standard replacement dose of recombinant methionyl GH was used, and therapy had no significant effect on TC or triglyceride (TG) levels. Apo C-III HP, a marker of hypertriglyceridemia, increased after the start of therapy, but no other lipoprotein levels changed significantly in the GH-deficient group. No changes were seen with treatment in the NS group. The longitudinal design of this study allowed demonstration of the later changes in the apolipoproteins and the presence of a distinct subset of patients with both GH deficiency and hypercholesterolemia. This study supports the role of GH in modulating lipid metabolism.