Visceral fat measurement by ultrasound, as a non-invasive method: Can be useful for evaluating the atherosclerosis in the patients with hypopituitarism and growth hormone deficiency?

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: SUN 649-677-Adipocyte Biology
Basic
Sunday, June 16, 2013: 1:45 PM-3:45 PM
Expo Halls ABC (Moscone Center)

Poster Board SUN-653
Oya Topaloglu1, Ferhat Gokay2, Salih Suha Koparal2, Gulhan Akbaba3, Turkan Mete2, Ayse Arduc3, Mazhar Muslum Tuna2, Yavuz Yalcin2, Dilek Berker3 and Serdar Guler*2
1Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey, 2Ministry of Health, Ankara Numune Training and Research Hospital, Ankara, Turkey, 3Ankara Numune Training and Research Hospital, Ankara, Turkey
Aims: Growth hormone (GH) deficiency either isolated or combined with other pituitary hormone deficiencies is associated with increased mortality from cardiovascular disease. Moreover, these patients have abnormal body composition with excess of visceral adiposity. Evaluation of VF by ultrasound is a non-invasive and simple method. The present study was therefore designed to investigate the effects of isolated GH deficiency, combination of GH and sex steroid deficiencies on ultrasonographic visceral fat (VF) thickness, and also cardiovascular risk factors  such as carotid intima-media thickness  (CIMT) in patients with hypopituitarism but on convensional hormone replacement therapy.

Patients and methods: Fourty hypopituitary patients (24 women, 16 men; mean-aged 48±16.1 years) with GH deficiency and 15 age- and sex-matched healthy controls were included to this cross-sectional study. The patients were stable on convensional hormone replacement therapy but not on GH therapy. Patients were divided into two groups according to isolated GH deficiency (Group 1; n=19) and combined GH and sex steroid deficiencies (Group 2; n=21). Anthropometrical measurements were evaluated. VF in three regions, subcutaneous fat, and carotid IMT were measured. VF volume was calculated by using a formula.  Cardiovascular risk markers, including high-sensitivity C-reactive protein (hs-CRP), homocysteine, lipid profile were evaluated. 

Results: Visceral fat volume and the mean CIMT were significantly higher in hypopituitary patients with GH deficiency than healthy controls (p=0.0001 and 0.019 respectively ). There was no difference in VF volume and CIMT between patients with isolated GH and combined sex-steroid and GH deficiencies (p>0.05). Triglyceride, total cholesterol, LDL-cholesterol were significantly higher in hypopituitary patients than controls (p=0.015, 0.001, and 0.004 respectively). Homocyteine and hs-CRP were higher in patients (p<0.05). There was no difference in cardiovascular risk biomarkers between Group 1 and Group 2 patients.VF volumes were significantly correlated with CIMT (r=0.539, p=0.047) and homocysteine(r=0.657, p=0.015) in males with GH deficiency.

Conclusion: Hypopituitary patients with isolated GH or combined GH and sex-steroid deficiencies have increased VF and cardiovascular risk biomarkers. VF measurement by ultrasound is an accurate, simple, non-invasive method in cardiovascular risk assessment for hypopituitary patients with isolated GH or combined GH and sex steroid deficiencies.

Nothing to Disclose: OT, FG, SSK, GA, TM, AA, MMT, YY, DB, SG

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm

Sources of Research Support: Aims: Growth hormone (GH) deficiency either isolated or combined with other pituitary hormone deficiencies is associated with increased mortality from cardiovascular disease. Moreover, these patients have abnormal body composition with excess of visceral adiposity. Evaluation of VF by ultrasound is a non-invasive and simple method. The present study was therefore designed to investigate the effects of isolated GH deficiency, combination of GH and sex steroid deficiencies on ultrasonographic visceral fat (VF) thickness, and also cardiovascular risk factors  such as carotid intima-media thickness  (CIMT) in patients with hypopituitarism but on convensional hormone replacement therapy. Patients and methods: Fourty hypopituitary patients (24 women, 16 men; mean-aged 48±16.1 years) with GH deficiency and 15 age- and sex-matched healthy controls were included to this cross-sectional study. The patients were stable on convensional hormone replacement therapy but not on GH therapy. Patients were divided into two groups according to isolated GH deficiency (Group 1; n=19) and combined GH and sex steroid deficiencies (Group 2; n=21). Anthropometrical measurements were evaluated. VF in three regions, subcutaneous fat, and carotid IMT were measured. VF volume was calculated by using a formula. Results: Visceral fat volume and the mean CIMT were significantly higher in hypopituitary patients with GH deficiency than healthy controls (p=0.0001 and 0.019 respectively ). There was no difference in VF volume and CIMT between patients with isolated GH and combined sex-steroid and GH deficiencies (p>0.05). Triglyceride, total cholesterol, LDL-cholesterol were significantly higher in hypopituitary patients than controls (p=0.015, 0.001, and 0.004 respectively). Homocyteine and hs-CRP were higher in patients (p<0.05). There was no difference in cardiovascular risk biomarkers between Group 1 and Group 2 patients.VF volumes were significantly correlated with CIMT (r=0.539, p=0.047) and homocysteine(r=0.657, p=0.015) in males with GH deficiency Conclusion: Hypopituitary patients with isolated GH or combined GH and sex-steroid deficiencies have increased VF and cardiovascular risk biomarkers. VF measurement by ultrasound is an accurate, simple, non-invasive method in cardiovascular risk assessment for hypopituitary patients with isolated GH or combined GH and sex steroid deficiencies.