Endocr Pract. 2018 Jan;24(1):33-39. doi: 10.4158/EP-2017-0007. Epub 2017 Nov 16.
Adult growth hormone deficiency (AGHD) is associated with cardiometabolic risk factors. Given that cardiovascular disease (CVD) is an important cause of morbidity and mortality in the AGHD population, there is a need for alternative, noninvasive methods of assessing cardiometabolic risk in this population. The Chinese visceral adiposity index (CVAI) is a new marker of visceral fat dysfunction based on age, body mass index (BMI), waist circumference (WC), and metabolic parameters. CVAI is well correlated with insulin resistance (IR) and is better at predicting metabolic syndrome (MS) than BMI and WC. This study aims to examine the reliability of the lipid accumulation product (LAP), visceral adiposity index (VAI), and CVAI as cardiometabolic risk markers in AGHD patients.
A total of 91 patients diagnosed with AGHD were divided into 4 groups according to CVAI quartile. We investigated the relationship between the patients' clinical and biochemical features, cardiometabolic risk assessed by cardiometabolic risk indices, the Framingham and atherosclerotic cardiovascular disease (ASCVD) risk scores, LAP, VAI, and CVAI.
The CVAI scores of patients were significantly higher than those of control patients. Increased CVAI significantly correlated with higher BMI, WC, waist-hip ratio (WHR), and triglycerides (TG), Framingham risk score and atherosclerotic cardiovascular disease lifetime risk score ( P≤.001), with lower growth hormone (GH) and high-density lipoprotein cholesterol (HDL-C) levels ( P≤.001).
Our results suggest that CVAI may be a good marker of cardiometabolic risk in AGHD patients and could be used to diagnose CVD development and vascular accidents.
AGHD = adult growth hormone deficiency; ASCVD = atherosclerotic cardiovascular disease; AUROC = area under the receiver operating characteristic curve; BMI = body mass index; CVAI = Chinese visceral adiposity index; CVD = cardiovascular disease; DBP = diastolic blood pressure; GH = growth hormone; GHRT = GH replacement therapy; HDL-C = high-density lipoprotein cholesterol; IGF-1 = insulin like factor-1; IGFBP-3 = insulin like factor binding protein-3; IR = insulin resistance; LAP = lipid accumulation product; MS = metabolic syndrome; SBP = systolic blood pressure; TC = total cholesterol; TG = triglycerides; VAI = visceral adiposity index; WC = waist circumference; WHR = waist-to-hip ratio.
成人生长激素缺乏症（AGHD）与心血管代谢危险因素相关。鉴于心血管疾病（CVD）是 AGHD 人群发病率和死亡率的重要原因，因此需要替代的、非侵入性的方法来评估该人群的心血管代谢风险。中国内脏脂肪指数（CVAI）是一种新的基于年龄、体重指数（BMI）、腰围（WC）和代谢参数的内脏脂肪功能障碍标志物。CVAI 与胰岛素抵抗（IR）密切相关，并且比 BMI 和 WC 更能预测代谢综合征（MS）。本研究旨在探讨脂质蓄积产物（LAP）、内脏脂肪指数（VAI）和 CVAI 作为 AGHD 患者心血管代谢风险标志物的可靠性。
根据 CVAI 四分位数，将 91 例确诊为 AGHD 的患者分为 4 组。我们研究了患者的临床和生化特征、通过心血管代谢风险指数评估的心血管代谢风险、弗雷明汉和动脉粥样硬化性心血管疾病（ASCVD）风险评分、LAP、VAI 和 CVAI 之间的关系。
患者的 CVAI 评分明显高于对照组。CVAI 升高与更高的 BMI、WC、腰臀比（WHR）和甘油三酯（TG）、弗雷明汉风险评分和 ASCVD 终生风险评分显著相关（P≤.001），同时与较低的生长激素（GH）和高密度脂蛋白胆固醇（HDL-C）水平相关（P≤.001）。
我们的结果表明，CVAI 可能是 AGHD 患者心血管代谢风险的一个良好标志物，并可用于诊断 CVD 发展和血管意外。
AGHD = 成人生长激素缺乏症；ASCVD = 动脉粥样硬化性心血管疾病；AUROC = 接受者操作特征曲线下面积；BMI = 体重指数；CVAI = 中国内脏脂肪指数；CVD = 心血管疾病；DBP = 舒张压；GH = 生长激素；GHRT = 生长激素替代疗法；HDL-C = 高密度脂蛋白胆固醇；IGF-1 = 胰岛素样因子-1；IGFBP-3 = 胰岛素样因子结合蛋白-3；IR = 胰岛素抵抗；LAP = 脂质蓄积产物；MS = 代谢综合征；SBP = 收缩压；TC = 总胆固醇；TG = 甘油三酯；VAI = 内脏脂肪指数；WC = 腰围；WHR = 腰臀比。
