A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .
Does a gender-related effect of growth hormone (GH) replacement exist on cardiovascular risk factors, cardiac morphology, and performance and atherosclerosis? Results of a two-year open, prospective study in young adult men and women with severe GH deficiency.
CONTEXT GH secretion and response to GH replacement are gender-related . OBJECTIVE The objective of this study was to investigate the effects of GH deficiency ( GHD ) and replacement on the cardiovascular system according to gender . DESIGN The design was open and prospect i ve . SETTING The study was conducted at a university hospital . SUBJECTS Subjects included 36 severe adult-onset GHD patients ( 18 men , 20 women , aged < 45 yr ) ; 36 gender- , age- , and body mass index-matched healthy subjects served as controls . INTERVENTIONS Subjects received GH replacement at a median dose of 6.5 microg/kg.d in men and 7.7 microg/kg.d in women for 2 yr . MAIN OUTCOME MEASURES Homeostasis model assessment index , total to HDL cholesterol ratio , fibrinogen and C-reactive protein levels , left ventricular mass index , blood pressure , heart rate , diastolic filling , and systolic function at rest and at peak exercise and intima-media thickness ( IMT ) at common carotid arteries were measured . RESULTS Basal prevalence and /or degree of insulin resistance , lipid alterations , compromised cardiac function , and IMT were similar in women and men . Diastolic dysfunction was more prevalent in men ( 61 vs. 25 % , P = 0.036 ) . After GH replacement , IGF-I levels normalized in all patients . Lipid profile , fibrinogen , and C-reactive protein levels normalized in all cases . The total to HDL ratio ( P = 0.04 ) was higher in women than men . The homeostasis model assessment index persisted higher in GHD patients than controls and decreased only in GHD men ( P = 0.017 ) . Left ventricular mass index normalized during treatment in both women and men , abnormal diastolic function persisted in three women ( P = 0.031 ) , and abnormal systolic performance persisted in six women and one man ( P = 0.13 ) . IMT decreased similarly in women and men , persisting higher than in controls . Exercise performance normalized in all . CONCLUSIONS Two-year GH replacement has similar beneficial effects on cardiac and exercise performance and atherosclerosis in women and men with severe GHD
A positive effect of GH treatment on CVD and fracture risk could be concluded , but study design limitations have to be considered .
Stroke and secondary brain tumours remained more prevalent .
Regrowth and recurrences of (peri)pituitary tumours were not increased in patients with GH treatment compared to similar patients without GH treatment .
All fatal and nonfatal malignancies were not more prevalent in  GH-treated adults compared to the general population .
Due to the positive effects demonstrated in r and omized clinical trials on cardiovascular surrogate markers and bone metabolism , a positive effect of growth hormone ( GH ) treatment on clinical ly relevant end-points seems feasible .
In this review , we discuss the long-term efficacy and safety of GH treatment in adult patients with growth hormone deficiency ( GHD ) with emphasis on morbidity : fatal and nonfatal cardiovascular disease ( CVD ) and stroke , fractures , fatal and nonfatal malignancies and recurrences , and diabetes mellitus .