Topaloglu Oya, Gokay Ferhat, Koparal Salih Suha, Akbaba Gulhan, Mete Turkan, Arduc Ayse, Tuna Mazhar Muslum, Yalcin Yavuz, Yavuz Halise Cinar, Berker Diler, Guler Serdar
Endokrynol Pol. 2014;65(3):195-202. doi: 10.5603/EP.2014.0027.
Growth hormone (GH) deficiency, either isolated or combined with other pituitary hormone deficiencies, is associated with increased mortality and abnormal body composition, particularly visceral adiposity. We aimed to investigate the effects of GH deficiency with or without sex steroid deficiencies on ultrasonographic visceral fat (VF) and cardiovascular risk markers in patients with hypopituitarism on conventional hormone replacement therapy.
Forty hypopituitarism patients (24 women, 16 men; mean age 48 ± 16.1 years) with GH deficiency and 15 age- and sex-matched healthy controls were included in this cross-sectional study. The patients were stable on conventional hormone replacement but they were not on GH therapy. Patients who had sex steroid replacement were classified as Group 1 (n = 19), and patients who did not use sex steroids were classified as Group 2 (n = 21). Anthropometric measurements were performed. VF in three regions, subcutaneous fat, and carotid intima-media thickness (CIMT) were measured. VF volume was calculated by using a formula.
Visceral fat volume and mean CIMT were significantly higher in patients than healthy controls (p = 0.001 and 0.019 respectively). Homocysteine and hs-CRP were higher in patients (p < 0.05). In males, VF volume and VF thickness measured between abdominal muscle and splenic vein were significantly correlated with CIMT (r = 0.54, p = 0.047 and r = 0.66, p = 0.010 respectively). Furthermore, there was a strong positive correlation between VF thickness in pararenal region and homocysteine (r = 0.74, p = 0.001) in males.
VF volume evaluated by ultrasound can be accepted as a cause of subclinical atherosclerosis in GH deficient hypopituitary patients, particularly males.
生长激素（GH）缺乏，无论是单独存在还是与其他垂体激素缺乏合并存在，都与死亡率增加和身体成分异常有关，尤其是内脏肥胖。我们旨在研究生长激素缺乏伴或不伴有性腺类固醇缺乏对接受传统激素替代治疗的垂体功能减退患者的超声内脏脂肪（VF）和心血管风险标志物的影响。
本横断面研究纳入了40例生长激素缺乏的垂体功能减退患者（24例女性，16例男性；平均年龄48±16.1岁）和15名年龄及性别匹配的健康对照者。患者接受传统激素替代治疗病情稳定，但未接受生长激素治疗。接受性腺类固醇替代治疗的患者分为第1组（n = 19），未使用性腺类固醇的患者分为第2组（n = 21）。进行了人体测量。测量了三个区域的内脏脂肪、皮下脂肪和颈动脉内膜中层厚度（CIMT）。通过公式计算内脏脂肪体积。
患者的内脏脂肪体积和平均CIMT显著高于健康对照者（分别为p = 0.001和0.019）。患者的同型半胱氨酸和高敏C反应蛋白更高（p < 0.05）。在男性中，腹肌与脾静脉之间测量的内脏脂肪体积和内脏脂肪厚度与CIMT显著相关（分别为r = 0.54，p = 0.047和r = 0.66，p = 0.010）。此外，男性肾旁区域的内脏脂肪厚度与同型半胱氨酸之间存在强正相关（r = 0.74，p = 0.001）。
超声评估的内脏脂肪体积可被视为生长激素缺乏的垂体功能减退患者，尤其是男性亚临床动脉粥样硬化的一个原因。
