ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2018) 15 4.5 | DOI: 10.1530/ey.15.4.5

ESPEYB15 4 Growth and Growth Factors Important for clinical practice (5 abstracts)

4.5 Growth hormone improves cardiopulmonary capacity and body composition in children with growth hormone deficiency

Capalbo D , Barbieri F , Improda N , Giallauria F , Di Pietro E , Rapacciuolo A , Di Mase R , Vigorito C & Salerno M


Department of Translational Medical Sciences, Pediatric Section, Federico II University of Naples, Naples, Italy


To read the full abstract: J Clin Endocrinol Metab 2017; 102(11):4080-4088

GH influences the structure and function of the heart. Untreated GHD adults have a worse cardiometabolic disease risk profile characterized by altered body composition, unfavorable changes in metabolism, reduced left ventricular mass and cardiac output and decreased exercise capacity [25-26]. GH replacement therapy normalizes the parameters associated with higher cardiovascular disease risk [27]. In children, GH replacement therapy, although mainly used to improve linear growth, has also effects on lipids, body composition and cardiovascular disease risk factors. The impact of GHD and GH replacement therapy on cardiopulmonary functional capacity of paediatric patients is unknown.

Consistent with findings in GHD adults, this prospective paediatric case-control study clearly shows that GHD affects cardiac structure, body composition and cardiopulmonary functional capacity and short-term GH therapy normalizes these features. On the basis of these results, the authors go as far as suggesting to perform cardiopulmonary exercise stress testing in the baseline evaluation of untreated GHD patients to unmask mild alterations of aerobic capacity. However, this advice is based on data on a small group of 21 patients. Further studies on larger cohorts of GHD children are needed before drawing definitive conclusions.

25. Isgaard J, Arcopinto M, Karason K, Cittadini A. GH and the cardiovascular system: an update on a topic at heart. Endocrine. 2015;48:25-35.

26. Gonzalez S, Sathyapalan T, Javed Z, Atkin SL. Effects of Growth Hormone Replacement on Peripheral Muscle and Exercise Capacity in Severe Growth Hormone Deficiency. Front Endocrinol. 2018;9:56.

27. Diez JJ, Sangiao-Alvarellos S, Cordido F. Treatment with Growth Hormone for Adults with Growth Hormone Deficiency Syndrome: Benefits and Risks. Int J Mol Sci. 2018;19(3).

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