BACKGROUND: Reports on the association between growth hormone deficiency (GHD) and caidiovascular risk factors in childien are limited. We aim to investigate the effect of different doses of recombinant human growth hormone (rhGH) therapy on blood lipid and carotid intima media thickness (cIMT) in Chinese GHD children. METHODS: Ninety children, including sixty isolated GHD children and thirty healthy children, were enrolled GHD children were randomly divided into two groups (A and B) according to the rhGH dose given group A received 0.23 mg/ kg/week and group B leceived 0.35 mg/kg/week for 12 months. The TC, TG, LDL-C, HDL -C, and cIMT at baseline and after treatment were measured. RESULTS: The height, weight, and height velocity improved significantly over 12 months of rhGH therapy in all GHD children. At baseline, GHD children in both the treatment groups showed significantly higher total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL C), cIMT, and lower high density lipoprotein cholesterol (HDL C) than healthy children (all P<0.033) After the 12-month rhGH therapy, a significant decrease in the TC, TG, LDL C, and cIMT, as well as a significant increase in the HDL C (P<0.046) was observed in the GHD children, with change in the group B being even more marked. CONCLUSIONS: The RhGH replacement therapy in GHD children can improve both the blood lipid profile and carotid intima media thickness, with higher dose rhGH therapy showing superior effects.