Background: The cardiovascular risk for children receiving treatment with GH has hardly been investigated. Therefore, we studied the relationships between GH treatment and carotid intima media-thickness (IMT), which is predictive for the cardiovascular diseases.
Methods: We measured carotid IMT (four values) in 100 children (mean age 11.6±2.8 years, 63% male) treated with GH (GH deficiency 61%, SGA 31%, Turner syndrome 5%, SHOX deficiency 2%, Prader-Willi syndrome 1%) and 100 age- and gender-matched healthy children without GH treatment. Furthermore, we analyzed blood pressure, lipids, HbA1c, IGF1, and IGFBP3 in children treated with GH. The mean duration of GH treatment was 4.4±2.2 years. This study has a power of 0.95 to detect differences in IMT with an α-error of 0.05 assuming an increase of IMT of 0.05 mm.
Results: The mean and maximum IMT levels did not differ significantly between children with and without GH treatment (max IMT in median 0.50 (interquartile range (IQR) 0.400.50) mm vs 0.50 (IQR 0.400.50) mm, P=0.506, mean IMT in median 0.43 (IQR 0.400.50) vs 0.45 (IQR 0.400.50) mm, P=0.582). There were no significant differences in the maximal IMT (P=0.941) nor in the mean IMT (P=0.644) between the different GH indication groups. In backwards linear regression analyses, mean IMT was significantly related to HbA1c (β coefficient: 0.06, 95% CI ±0.05, P=0.017, r2=0.05), but not to age, gender, BMI, duration or doses of GH treatment, indication of GH treatment, IGF1, IGFBP-3 nor to any cardiovascular risk factor. Furthermore, maximal IMT was not related to age, gender, BMI, duration or doses of GH treatment, indication of GH treatment IGF1 levels, or to any cardiovascular risk factor.
Conclusions: We found no evidence that GH treatment is associated with changes in the cardiovascular system measurable by IMT.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology