The metabolic outcomes of growth hormone treatment in children are gender specific.

Objective: To evaluate the impact of gender on the clinical and metabolic parameters in prepubertal growth hormone deficiency (GHD) children at diagnosis and during GH treatment (GHT).

Design: The data of 105 prepubertal children (61 males, 44 females, mean age 6.8 ± 0.7 years) affected by idiopathic GHD were retrospectively evaluated.

Methods: Body height, BMI, waist circumference (WC), IGF-I, HbA1c, lipid profile, fasting and after-OGTT glucose and insulin levels, insulin sensitivity and secretion indices were evaluated at baseline and after 24 months of GHT.

Results: At baseline, no significant difference was found in all clinical, hormonal and metabolic parameters between males and females. After 24 months of GHT, both males and females showed a significant increase in height (both  < 0.001), BMI (both  < 0.001), WC ( < 0.001 and  = 0.004, respectively), IGF-I (both  < 0.001), fasting glucose ( < 0.001 and  = 0.001, respectively), fasting insulin (both  < 0.001) and Homa-IR (both  < 0.001), with a concomitant significant decrease in insulin sensitivity index (ISI) (both  < 0.001) and oral disposition index (DIo) ( = 0.001 and  < 0.001, respectively). At 24 months of GHT, females showed significantly higher BMI ( = 0.027), lower ISI ( < 0.001) and DIo ( < 0.001), in concomitance with a significant greater change from baseline to 24 months of BMI ( = 0.013), WC ( < 0.001), ISI ( = 0.002) and DIo ( = 0.072), although the latter does not reach statistical significance.

Conclusions: Twenty-four months of GHT in prepubertal children leads to different metabolic outcomes according to gender, with a greater reduction in insulin sensitivity in females, regardless of auxological and hormonal parameters. Therefore, prepubertal GHD females should probably need a more proper monitoring in clinical practice.