Abstract
AimAdult growth hormone deficiency (AGHD) refers to decreased secretion of growth hormones in the adults, which is associated with increased clustering of conventional cardiovascular risk factors such as central obesity, insulin resistance and dyslipidemia. Metabolic syndrome (MetS), a recognized risk factor of cardiovascluar diseases, shares some clinical features. Given that the prevalence of MetS is on the rise in patients with AGHD, and that cardiovascular disease (CVD) is an important cause of morbidity and mortality in that population, the alternative, simple, non-invasive methods of assessing MetS among this population are needed. This study aims to determine the sensitivity of five anthropometric indices [Body mass index (BMI), Waist circumference (WC), Waist-to-hip ratio (WHR), Waist-to-height ratio (WHtR) and Visceral adiposity index (VAI)] in predicting metabolic syndrome in Chinese population-based patients with adult growth hormone deficiency.Materials and methodsA total of 96 Chinese patients with adult growth hormone deficiency were included in this study. They were compared with equal number of apparently healthy persons with similar characteristics (matched with age and gender) to the previous group. Anthropometric measurements including weight, height, serum lipids indices, blood pressure (BP), fasting plasma glucose (FPG), WC were measured. BMI, WHR, WHtR, and VAI were calculated.Results and discussionAGHD patients with MetS had higher WC (91.00 ± 8.28 vs 78.01 ± 7.12), BMI (24.95 ± 2.91 VS 23.30 ± 2.80), WHR (0.92 ± 0.06 VS 0.87 ± 0.07), WHtR (0.53 ± 0.06 VS 0.47 ± 0.05), VAI [(5.59 (4.02, 7.55) VS 1.69 (0.87, 3.05)] levels in comparison to those without MetS. Meantime WC, BMI, WHR, WHtR, VAI was positively correlated to MetS components. ROC curve for participants with AGHD showed that VAI had the highest SS of 92% (BMI 0.812; WHR 0.706; WHtR 0.902; VAI 0.920, respectively) for prediction of MetS in AGHD. The optimal cutoff values for different adiposity markers in predicting MetS were as follows: WC (79.65), BMI (23.46); WHR (0.89); WHtR (0.54); VAI (2.29).ConclusionIn conclusion, our study showed all adiposity measures of interest present themselves as easy and practical tools for use in population studies and clinical practice for evaluating MetS in AGDH and VAI was identified as the best in Chinese AGHD patients among them.
Highlights
Adult growth hormone deficiency (AGHD) refers to decreased secretion of growth hormones in the adults, which results from diseases of the pituitary gland or from diseases of the hypothalamus
Meantime Waist circumference (WC), body mass index (BMI), Waist-to-hip ratio (WHR), Waist-to-height ratio (WHtR), Visceral adiposity index (VAI) was positively correlated to Metabolic syndrome (MetS) components
receiver operating characteristic (ROC) curve for participants with AGHD showed that VAI had the highest SS of 92% (BMI 0.812; WHR 0.706; WHtR 0.902; VAI 0.920, respectively) for prediction of MetS in AGHD
Summary
Adult growth hormone deficiency (AGHD) refers to decreased secretion of growth hormones in the adults, which results from diseases of the pituitary gland or from diseases of the hypothalamus. The clinical manifestations of AGHD depend upon the cause as well as the type and degree of hormonal insufficiency. Increased clustering of conventional cardiovascular risk factors such as central obesity, insulin resistance and dyslipidemia has been demonstrated in patients with AGHD. According to the World Health Organization (WHO) or the National Cholesterol Education Program—Third Adult Treatment Panel (ATP III), Metabolic syndrome (MetS) is increasingly recognized as a distinct entity which comprises the following components: central obesity, hyperglycaemia, hypertension and dyslipidaemia [2, 3]. It pointed out that the MetS shares clinical features with adult growth hormone deficiency such as central obesity, insulin resistance and dyslipidemia. One of other features common to both conditions is premature atherosclerosis and increased mortality from cardiovascular diseases [4, 5]
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