Abstract
Objective Patients with adult growth hormone deficiency (AGHD) confer a heightened risk of cardiovascular disease and increased mortality because of metabolic disorders. Growth differentiation factor-15 (GDF-15) plays an important role in predicting metabolic abnormalities. We sought to investigate the correlation between GDF-15 and cardiovascular risk in AGHD patients. Methods The study enrolled 80 AGHD patients and 80 healthy subjects. We analyzed the association between GDF-15 and some major biochemical indicators. The potential association between GDF-15 and cardiovascular disease risk was analyzed. Results The AGHD group exhibited increased waist-hip ratio and high-sensitivity C-reactive protein (hs-CRP) and lipid levels compared with the healthy control group. Serum GDF-15 levels in AGHD group were elevated significantly compared with the control group (P < 0.001). GDF-15 levels were negatively associated with insulin-like growth factor-1 in AGHD group (P=0.006) and positively correlated with waist-to-hip ratio (P=0.018), triglycerides (P=0.007), and hs-CRP (P=0.046). In addition, GDF-15 was positively correlated with Framingham risk score significantly after adjustment for other factors (r = 0.497, P < 0.001). Moreover, GDF-15 was an independent risk factor for cardiovascular disease in AGHD patients after adjusting for traditional cardiovascular risk factors. Conclusion Elevated GDF-15 levels were significantly associated with cardiovascular risk factors and can be considered as a predictive biomarker of cardiovascular risk in AGHD patients.
Highlights
Growth hormone (GH) affects linear growth in childhood, but GH plays an important role in glucose and lipid metabolism in adulthood mainly by insulin-like growth factor-1 (IGF-1) [1, 2]
All the patients were diagnosed according to insulin tolerance test (ITT), and patients with GH peak value < 5.0 μg/L were diagnosed with Adult growth hormone deficiency (AGHD) [15]. is AGHD group included 38 patients with a pituitary adenoma who had been treated with surgery for more than one year, 13 with Sheehan’s syndrome, and 20 with pygmyism as well as 9 patients who possibly had idiopathic growth hormone deficiency
Growth differentiation factor-15 (GDF-15) was negatively correlated with IGF-1 (r −0.303, P 0.006; Figure 2(a)), while GDF-15 was positively correlated with waist-hip ratio (WHR) (r 0.26, P 0.018; Figure 2(b)), TG (r 0.323, P 0.007; Figure 2(c)), TC (r 0.196, P 0.099; Figure 2(d)), high-sensitivity C-reactive protein (hs-CRP) (r 0.248, P 0.046; Figure 2(e)), and Framingham risk score (FRS) (r 0.428, P < 0.001; Figure 2(f ))
Summary
Growth hormone (GH) affects linear growth in childhood, but GH plays an important role in glucose and lipid metabolism in adulthood mainly by insulin-like growth factor-1 (IGF-1) [1, 2]. Adult growth hormone deficiency (AGHD) is characterized by increased visceral obesity, dyslipidemia, and insulin resistance [3]. Metabolic syndrome is highly prevalent in AGHD, which results in increased risks of cardiovascular disease (CVD) [4,5,6,7]. CVD in patients with AGHD may occur earlier than in the ordinary people [8]. AGHD, despite its relative rarity, contributes to increased mortality on account of elevated CVD morbidity [6, 9]. Erefore, identification of early predictive biomarkers of CVD and primary prevention should begin as soon as possible. There is no specific biomarker to predict cardiovascular risk of AGHD patients
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