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Prepubertal children with GH deficiency face early CV risks
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Prepubertal children with growth hormone deficiency already present with several cardiovascular risk markers, including abnormal lipid profiles, elevated inflammatory and oxidative stress markers, and reduced cardiac mass, according to a recent review.
In an analysis of studies examining CV risk markers in children with GH deficiency, researchers noted that recombinant human GH (rhGH) therapy can lower the burden of CVD risk in children, although further studies are needed to evaluate the long-term effect of rhGh treatment.
“Prepubertal children with untreated GH [deficiency] have been found to have increased carotid intima-media thickness compared to a control population and have a higher risk for developing CVD at an early age,” Chiara De Leonibus, MD, of the department of pediatrics at the University of Chieti in Italy, and colleagues wrote. “Therefore, the identification of early predictive markers of atherosclerotic CVD and primary prevention should begin in childhood.”
The researchers found that rhGH therapy induces favorable change in lipid profiles, reduces C-reactive protein and fibrinogen levels, and reduced the morphological and functional parameters of erythrocytes to normal levels. GH replacement therapy also increased both left ventricular mass and left ventricular mass index in children, whereas studies in adolescents with GH deficiency also showed an increase in epicardial adipose tissue after rhGH therapy.
Several recent studies also suggest that epigenetic mechanisms that occur very early in life may play a role in GH deficiency and cardiometabolic changes, according to researchers.
“Novel epigenetic and metabolomics markers are now emerging that could be utilized as clinical tools to detect distinctive fingerprints to help in predicting those children with GH [deficiency] and other growth disorders who are at an increased risk of CVD,” the researchers wrote. “The novelty of these studies resides in a better understanding of the epigenetic and metabolomics changes related to GH [deficiency], which are not permanent and could be reversed by rhGH therapy.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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