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生长激素缺乏症成年患者血清脂联素升高与心血管风险增加相关。

CORRELATION OF INCREASED SERUM ADIPSIN WITH INCREASED CARDIOVASCULAR RISKS IN ADULT PATIENTS WITH GROWTH HORMONE DEFICIENCY.

出版信息

Endocr Pract. 2019 May;25(5):446-453. doi: 10.4158/EP-2018-0541. Epub 2019 Jan 18.

Abstract

Adult growth hormone deficiency (AGHD) patients have an increased cardiovascular morbidity and mortality. Adipsin is an adipokine that is significantly correlated with metabolic disease, especially in people with obesity. The objective of our study was to compare AGHD patients with healthy subjects to evaluate whether adipsin levels are closely related to glycolipid metabolism and cardiovascular risks in AGHD patients. Our study included 88 AGHD patients and 88 age-, weight-, and body mass index (BMI)-matched healthy subjects. Anthropometric parameters such as BMI, waist circumference, and blood pressure were measured. Biochemical indicators such as serum adipsin, lipids, and fasting insulin levels were determined. Adipsin levels in AGHD patients were significantly increased compared to levels of the control group (11,567.29 ng/mL, interquartile [9,856.46 to 13,360.60 ng/mL]) versus (9,127.86 ng/mL, interquartile [8,061.82 to 10,647.06 ng/mL], = .000). Increased serum adipsin levels are correlated with cardiovascular risk factors such as a higher waist-to-hip ratio, serum lipids levels, and insulin resistance. Adipsin levels were inversely related to insulin-like growth factor 1 (IGF-1) (r = -0.6363, <.0001) and insulin-like growth factor binding protein 3 levels (r = -0.498, <.0001). The odds ratio (OR) for AGHD in the highest quartile was found to be 4.491 times the ratio in the lowest quartile (OR = 4.491, = .048). Additionally, adipsin was found to be the most independent factor to influence IGF-1 levels in AGHD subjects. The serum levels of adipsin were significantly correlated with glucolipid metabolism disorder with a growth hormone deficiency status. Furthermore, serum levels of adipsin might be a good marker for the occurrence and development of cardiovascular diseases in AGHD patients. = adult growth hormone deficiency; = atherosclerotic cardiovascular disease; = body mass index; = diastolic blood pressure; = fasting insulin; = fasting plasma glucose; = growth hormone; = homeostatic model to assess insulin resistance index; = high-sensitivity C-reactive protein; = insulin-like growth factor 1; = insulin-like growth factor binding protein 3; = lipid accumulation products; = low-density lipoprotein; = systolic blood pressure; = total cholesterol; = triglycerides; = waist circumference; = waist-to-hip ratio; = odds ratio.

摘要

成人生长激素缺乏症(AGHD)患者心血管发病率和死亡率增加。脂联素是一种与代谢疾病密切相关的脂肪因子,尤其是在肥胖人群中。我们的研究目的是比较 AGHD 患者与健康受试者,以评估脂联素水平是否与 AGHD 患者的糖脂代谢和心血管风险密切相关。

我们的研究纳入了 88 例 AGHD 患者和 88 例年龄、体重和体重指数(BMI)匹配的健康受试者。测量了 BMI、腰围和血压等人体测量参数。测定了血清脂联素、血脂和空腹胰岛素等生化指标。

与对照组相比,AGHD 患者的脂联素水平明显升高(11567.29 ng/ml,四分位距[9,856.46 至 13,360.60 ng/ml])(9127.86 ng/ml,四分位距[8,061.82 至 10,647.06 ng/ml], =.000)。血清脂联素水平升高与心血管危险因素相关,如腰臀比、血清脂质水平和胰岛素抵抗较高。脂联素水平与胰岛素样生长因子 1(IGF-1)呈负相关(r = -0.6363,<.0001),与胰岛素样生长因子结合蛋白 3 水平呈负相关(r = -0.498,<.0001)。发现脂联素最高四分位数的 AGHD 比值为最低四分位数的 4.491 倍(比值=4.491,=.048)。此外,脂联素被发现是影响 AGHD 受试者 IGF-1 水平的最独立因素。

血清脂联素水平与生长激素缺乏状态下的糖脂代谢紊乱显著相关。此外,血清脂联素水平可能是 AGHD 患者心血管疾病发生和发展的良好标志物。

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