Is the impact of recombinant human growth hormone (rhGH) on the plasma lipid profile beneficial or harmful?

Growth hormone (GH) can modulate the metabolism of lipoproteins by affecting both their secretion and uptake by the liver and their catabolism by lipolytic enzymes in plasma. Clinical studies in adults indicate that patients with GH deficiency have atherogenic lipoprotein profiles that are ameliorated by GH administration. However, in children with GH deficiency or chronic renal insufficiency (CRI), just modest changes in total plasma lipids and lipoprotein profiles have been observed. In contrast, GH administration results in a significant increase in lipoprotein(a) (Lp(a)) levels that does not seem to be mediated by IGF-I but rather by the direct effect of GH on the hepatic secretion of Lp(a). In patients with CRF, Lp(a) is frequently elevated and GH administration may lead to a further increase in plasma levels necessitating monitoring of this highly atherogenic particle during rhGH treatment.