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The effects of growth hormone (GH) replace- ment on plasma lecithin:cholesterol acyltransferase (LCAT), cholesteryl ester transfer protein (CETP), and phospho- lipid transfer protein (PLTP), factors involved in high den- sity lipoprotein (HDL) metabolism, are unknown. We car- ried out a 6 months study in 24 GH-deficient adults who were randomized to placebo (n 5 8), low dose GH (1 U daily, n 5 8), and high dose GH (2 U daily, n 5 8), followed by a 6 months open extension study with high dose GH (1 drop- out). No significant changes in plasma lipoproteins, LCAT, CETP, and PLTP activities, cholesterol esterification (EST) and cholesteryl ester transfer (CET) were observed after placebo. After 6 months of GH (combined data, n 5 24), very low 1 low density lipoprotein (VLDL 1 LDL) choles- terol ( P , 0.05) and apolipoprotein B ( P , 0.05) decreased, whereas HDL cholesterol and HDL cholesteryl ester in- creased ( P , 0.05). Prolonged treatment showed compa- rable effects. Plasma apolipoprotein A-I and Lp(a) remained unchanged. Plasma LCAT ( P , 0.01) and CETP activities ( P , 0.01), as well as EST ( P , 0.01) and CET decreased ( P , 0.01) after 12 months of GH (n 5 15), but PLTP activity did not significantly change. Changes in EST and CET after 12 months of treatment were independently related to changes in plasma LCAT ( P 5 0.001 and CETP activity ( P 5 0.01). In conclusion, GH replacement therapy improves the lipo- protein profile in GH-deficient adults. Chronic GH replace- ment lowers plasma LCAT and CETP activities, contributing to a decrease in cholesterol esterification and cholesteryl es- ter transfer. These effects may have consequences for HDL metabolism and reverse cholesterol transport. —Beentjes, J. A. M., A. van Tol, W. J. Sluiter, and R. P. F. Dullaart. Effect of growth hormone replacement therapy on plasma lecithin: cholesterol acyltransferase and lipid transfer protein activi- ties in growth hormone-deficient adults. J. Lipid Res. 2000. 41: 925-932.