Endocrinology and Diabetology Unit, Department of Medical Sciences, University of Milan, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.
Nutr Metab Cardiovasc Dis. 2013 May;23(5):459-65. doi: 10.1016/j.numecd.2011.09.001. Epub 2011 Nov 25.
Growth Hormone Deficiency (GHD) is characterized by increased visceral fat accumulation. Echocardiographic epicardial fat thickness is a new marker of visceral adiposity. Aim of the present study was to evaluate whether epicardial fat thickness can significantly change and therefore serve as a marker of visceral fat reduction after short-term rhGH replacement therapy in patients with adult-onset GHD.
Echocardiographic epicardial fat thickness was measured in 18 patients (10 M, 8 F, age 48 ± 11.8 yrs, BMI 29 ± 5.9 kg/m(2)) with adult-onset GHD, at baseline and after 6 and 12 months of rhGH therapy and in 18 healthy matched controls, at baseline. Echocardiographic epicardial fat thickness, conventional anthropometric and metabolic parameters, body fat percentage and quality of life were also evaluated. Epicardial fat thickness in adult GHD patients was higher than in controls (9.8 ± 2.8 vs 8 ± 3 mm, p < 0.05). Epicardial fat thickness significantly decreased after 6-months of rhGH replacement therapy (from 9.8 ± 2.8 to 7.0 ± 2.3 mm, P < 0.01, i.e. -29% from baseline). After 12 months of rhGH replacement therapy, epicardial fat thickness showed a further significant decrease (from 7.0 ± 2.3 to 5.9 ± 3.1 mm, P < 0.01, i.e. -40% from baseline). No significant changes in BMI or waist circumference after 6 or 12 months of rhGH therapy were observed.
Echocardiographic epicardial fat thickness may represent a valuable and easy marker of visceral fat and visceral fat changes during rhGH replacement treatment in patients with adult-onset growth hormone deficiency.
生长激素缺乏症(GHD)的特征是内脏脂肪堆积增加。超声心动图心外膜脂肪厚度是内脏肥胖的新标志物。本研究旨在评估短期 rhGH 替代治疗后,心外膜脂肪厚度是否会显著变化,从而成为成年起病 GHD 患者内脏脂肪减少的标志物。
在 18 名成年起病 GHD 患者(10 名男性,8 名女性,年龄 48 ± 11.8 岁,BMI 29 ± 5.9kg/m2)中测量超声心动图心外膜脂肪厚度,分别在基线时、rhGH 治疗 6 个月和 12 个月时以及 18 名健康匹配的对照组中测量基线时的超声心动图心外膜脂肪厚度、常规人体测量和代谢参数、体脂肪百分比和生活质量。心外膜脂肪厚度在成年 GHD 患者中高于对照组(9.8 ± 2.8 与 8 ± 3mm,p < 0.05)。rhGH 替代治疗 6 个月后,心外膜脂肪厚度显著降低(从 9.8 ± 2.8 降至 7.0 ± 2.3mm,P < 0.01,即从基线降低 29%)。rhGH 替代治疗 12 个月后,心外膜脂肪厚度进一步显著降低(从 7.0 ± 2.3 降至 5.9 ± 3.1mm,P < 0.01,即从基线降低 40%)。rhGH 治疗 6 或 12 个月后,BMI 或腰围无明显变化。
超声心动图心外膜脂肪厚度可能是成年起病生长激素缺乏症患者 rhGH 替代治疗期间内脏脂肪和内脏脂肪变化的一个有价值且易于测量的标志物。