LONG-TERM PROSPECTIVE-STUDY OF BODY-COMPOSITION AND LIPID PROFILES DURING AND AFTER GROWTH-HORMONE (GH) TREATMENT IN CHILDREN WITH GH DEFICIENCY - GENDER-SPECIFIC METABOLIC EFFECTS

GH has many effects on metabolism in addition to promoting growth We s tudied changes in body composition and lipid profiles during and after GH treatment in 94 children with GH deficiency. Sixty-two subjects (4 6 boys and 16 girls) were evaluated at the beginning and during 36 mon ths of GH treatment. The other 32 (21 boys and 11 girls) who had alrea dy been treated with GH were examined after the discontinuation of GH for a g-month period. The height sn scores at the beginning and the di scontinuation of GH treatment were -2.81 and -1.34 in boys and -3.14 a nd -1.38 in girls, respectively. The percent body fat (BF) significant ly decreased from 16.5% to 11.7% in boys and from 16.7% to 11.6% in gi rls during the first 6 months of GH treatment (P < 0.01). BF subsequen tly remained constant in boys, but started to increase in girls from t he 18th month of treatment. Lean body mass (kilograms) increased linea rly throughout the treatment in both sexes (P < 0.01). Mean total chol esterol (TC) values decreased as a result of marked declines in low de nsity lipoprotein cholesterol in both sexes, although statistical sign ificance was detected only in boys (P < 0.01). High density lipoprotei n cholesterol (HDLC) and apolipoprotein AI (Apo-AI) rapidly increased only in boys (P < 0.01). Triglyceride, Apo-AII, Apo-B, Apo-CII, Apo-CI II, Apo-E, and lipoprotein(a) showed no significant changes compared w ith baseline levels. Mean TC/HDLC and Apo-B/Apo-AI ratios decreased du ring treatment in both sexes, but the difference from baseline was sig nificant only in boys (P < 0.01). After discontinuation of GH treatmen t, BF increased, and lean body mass decreased in boys (P < 0.01), wher eas these variables did not change in girls. TC and low density lipopr otein cholesterol increased in boys within 6 months of discontinuing G H (P < 0.05). Other lipoproteins did not change in either sex, except for lipoprotein(a), which decreased significantly 6 months after the c essation of GH treatment in boys (P < 0.01). The mean TC/HDLC and Apo- B/Apo-AI ratios increased in boys slightly, but insignificantly. We co ncluded that GN treatment has beneficial effects on body composition a nd Lipid profiles in both boys and girls with GH deficiency, although there are considerable gender differences. These beneficial effects of GI-I were reversed after the discontinuation of GH treatment, suggest ing an important role of GH for GH-deficient children in the maintenan ce of normal metabolism even after the completion of linear growth.