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December 21, 2020

Cardiovascular Disease in Former Pediatric Recipients of Growth Hormone: Another Look at Growth Hormone Safety

Author Affiliations
  • 1Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
  • 2Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
JAMA Pediatr. 2021;175(2):e205232. doi:10.1001/jamapediatrics.2020.5232

In this issue of JAMA Pediatrics, Tidblad et al1 report a Swedish nationwide cohort study of 3408 adults who had received growth hormone treatment during childhood from 1985 to 2010 for isolated growth hormone deficiency (GHD), small for gestational age without catch-up growth (SGA), or idiopathic short stature (ISS). Cardiovascular events through 2014 were compared between this register-based cohort and control individuals matched 15:1 for age, sex, and county (n = 50 036) randomly selected from the Swedish Total Population Register. Data on select covariates were collected from various national health and population registers and linked by the individuals’ unique personal identity numbers. The adjusted hazard ratio for all cardiovascular events was higher in patients than controls overall (1.69; 95% CI, 1.30-2.19), in each indication subgroup, for severe cardiovascular events only, and in particular in females. As the authors state, “Conclusions of causality are still limited and the absolute risk remains low.”

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