Context: GH deficiency in adults is associated with a cluster of cardiovascular risk factors, which may contribute to an increased mortality for cardiovascular disease.

Objective: To evaluate the effect of GH deficiency (GHD) and GH replacement therapy on cardiac performance, lipid profile and insulin resistance in children.

Design: This was a 2-years case-control prospective study

Patients: Thirty children with GHD aged 9.3 ± 0.5 yr and 30 healthy matched controls were studied.

Intervention: Children were studied before and after 1 and 2 yr of GH replacement (GHD children) or no treatment (controls)

Main Outcome Measures: Lipid profile, serum insulin levels, HOMA index and left ventricular (LV) mass and function by echocardiography.

Results: At study entry, the LV mass index (LVMi) was significantly lower in GHD children (50.2 ± 1.7) than in controls (60.3 ± 2.5 g/m², P < 0.002), whereas LV systolic and diastolic function, lipid profile, insulin levels, and HOMA index, were similar. In GHD children LVMi significantly increased (66.3 ± 2.4 g/m², P < 0.0001) after 1 yr of GH replacement and remained stable thereafter. LV systolic and diastolic function did not change during treatment. After 2 yr of GH replacement, total-cholesterol (P < 0.007) and the atherogenic index (P < 0.0001) significantly decreased, while fasting insulin levels (P < 0.001) and HOMA index (P < 0.0001) significantly increased compared with both pre-treatment and control values.

Conclusions: GHD in children is associated with a reduced cardiac size, but with a normal cardiac function, lipid profile and insulin sensitivity. Two years of GH replacement normalizes cardiac morphology, improves lipid profile and slightly impairs insulin sensitivity.