Cardiac effects of growth hormone treatment in pediatric populations

While the full extent of the role that growth hormone (GH) and its effector Insulin-like growth factor 1 (IGF-1) play in the development and maintenance of cardiovascular morphology and function is debated, several conditions associated with altered GH activity have characteristic cardiovascular impairments.[1-3] The effects of GH therapy on cardiac function have been studied in the pediatric population, primarily in the setting of GH deficiency. For individuals whose circulating levels of GH are low, GH replacement therapy appears to improve cardiovascular health. GH therapy has also been shown to improve lean body mass and decrease percent body fat, which may further improve overall cardiovascular health. However, GH excess may lead to cardiac hypertrophy, as seen in acromegaly. GH therapy may also lead to reduced insulin sensitivity, a pre-diabetic state, in some individuals, particularly women with Turner syndrome. Thus, the systemic effects of GH therapy, specifically its effect on the cardiovascular system, vary by underlying condition.