Background. Severe GH deficiency (GHD) is associated with, increased cardiovascular (CV) risk and intima-media thickness (IMT) at major arteries.

Objective. To investigate the 5-yrs effects of GH replacement on common carotid IMT and insulin resistance (IR) syndrome (IRS) (at least two of: triglycerides levels 1.7 mmol/liter, HDL-cholesterol levels 1.0 mmol/liter, blood pressure above 130/85 mmHg, fasting glucose 6.1–7 or 2 hr after glucose 7.7–11.1 mmol/liter).

Design. Interventional, open, prospective, controlled.

Patients. 35 men with severe GHD and 35 age-matched healthy men as control.

Intervention. All patients received standard replacement therapy; GH replacement was added in 22 patients (Group A) and refused by 13 others (Group B).

Measurements. 5-years changes in IMT and IRS prevalence.

Results. At baseline, IMT was higher in the patients with (p<0.001) and without IRS (p=0.004) than in controls. 18 patients (51.4%) and two controls (5.7%; p<0.0001) had IRS. At study end, use of lipid lowering drugs (92.3%, vs. 13.6% and 34.3%, p<0.0001), glucose lowering drugs (69.2% vs. 31.4% and 22.7%; p=0.016) and anti-hypertensive drugs (61.5% vs. 20.0% and 4.5%; p<0.0001) was higher in Group B patients than in controls and in Group A patients. IGF-I levels normalized in all Group A patients and remained lower than -1 SDS in 77% of Group B patients. IMT significantly decreased only in Group A, while significantly increased in controls and non significantly in group B patients. IRS prevalence significantly reduced only in group A patients.

Conclusions. Severely hypopituitary GHD men have more frequently increased IMT at common carotid arteries and IRS than controls. After 5 years, only in GH replaced patients IMT and prevalence of IRS decreased.