Metabolic effects of growth hormone (GH) deficiency and GH replacement therapy in children and adolescents

Adults with severe growth hormone (GH) deficiency (GHD) may develop a cluster of cardiovascular risk factors that may contribute to a reduced life expectancy with increased mortality due to cardiovascular disease. In adolescents with severe GHD there is also increasing evidence which suggests that the discontinuation of GH replacement therapy at the completion of linear growth may result in adverse effects on body composition, lipid profile, cardiac morphology and performance. In contrast, relatively few studies have investigated whether or not children with GHD have metabolic and cardiac abnormalities that may place them at higher risk of cardiovascular disease at an early age. This review focuses on the effect of both GHD and GH replacement on cardiovascular risk factors in children and adolescents with GHD.