INVITED COMMENTARY Lipoprotein(a) and growth hormone: is the puzzle solved?

Recombinant human growth hormone (rhGH) is now used routinely in the treatment of congenital and acquired GH deficiency (GHD). Additional indications for long-term administration of rhGH such as osteo-porosis and aging have been proposed, but concerns regarding the safety of such prolonged courses of rhGH have been raised. Administration of rhGH is associated with glucose intolerance, higher plasma insulin con-centrations and fluid retention. To add to these potential problems is the finding that rhGH may increase plasma concentrations of the atherogenic lipoprotein(a) (Lp(a)) particle (1, 2). In Caucasians, increased plasma concentrations of Lp(a) are associated with an increased risk of cardio-vascular disease (3), but the mechanism by which Lp(a