Metabolic abnormalities in growth hormone deficiency.

Growth hormone has been implicated in the regulation of cardiovascular function and growth hormone deficiency (GHD) has been postulated to be one of the main factors responsible for the increased morbidity and mortality from cardiovascular disease in both young and older patients with childhood- and adulthood-onset GHD. Growth hormone also influences bone turnover and mineral deposition. Subjects with growth hormone deficiency have been shown to have an increased cardiovascular risk as manifested by elevated fasting and postprandial lipids and by increased body fat. In addition, premature atherosclerosis, decreased fibrinolytic activity, increased peripheral insulin resistance, abnormal cardiac structure and impaired cardiac performance have also been reported in this group of patients. Short and long term growth hormone treatment has been shown to exert beneficial effects on several of these parameters. While most of these abnormalities have been reported in adult GHD patients, metabolic changes in GHD children and adolescents have only recently begun to be investigated in more detail.