Exploring the sex difference in cardiovascular risk during growth hormone therapy in adults.

Men with growth hormone deficiency had a more unfavorable cardiovascular risk profile than women at baseline.

• Study included 1335 men and 1251 women with severe GHD registered in the Dutch National Registry of GH Treatment in Adults database
• Baseline differences in CV risk profile were assessed prior to initiation of GH replacement therapy
• Men showed worse baseline metrics across multiple cardiovascular risk parameters compared to women
• This was a retrospective nationwide cohort study design

During the first years of GHRT, reductions in waist circumference, waist-to-hip ratio, total cholesterol, and triglyceride levels were greater in men than in women.

• All between-sex differences in these early treatment effects reached statistical significance (all P < .05)
• The four parameters showing greater male benefit were waist circumference, waist-to-hip ratio, total cholesterol, and triglyceride levels
• These differences were observed specifically during the first years of GHRT
• Between-sex differences in effects during later follow-up were described as 'less clear'

No sex differences were found in the risk of developing non-fatal cardiovascular or cerebrovascular diseases during GHRT.

• Despite men having a more unfavorable CV risk profile at baseline, this did not translate into a sex difference in CV or cerebrovascular morbidity outcomes
• Both cardiovascular and cerebrovascular disease endpoints were assessed during follow-up
• Only non-fatal events were analyzed for these morbidity outcomes
• This finding applied across the full follow-up period in the Dutch National Registry of GH Treatment in Adults

The study confirmed the hypothesis that women experience less beneficial effects than men from GHRT on body composition and lipoprotein metabolism, at least in early treatment years.

• The stated hypothesis was that women would experience less beneficial effects than men
• Results supported this hypothesis specifically for body composition (waist circumference, waist-to-hip ratio) and lipoprotein metabolism (total cholesterol, triglycerides)
• The sex difference in treatment efficacy was most pronounced in the early years of treatment
• The advantage for men diminished over longer follow-up periods