Individual risk factors of the metabolic syndrome in adult patients with growth hormone deficiency--a cross-sectional case-control study.
Individual risk factors of the metabolic syndrome in adult patients with growth hormone deficiency--a cross-sectional case-control study.
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DOI：
10.1055/s-0034-1390460
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发表时间：
2014-11
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通讯作者：
Ivayla Uzunova;G. Kirilov;Sabina Zacharieva;A. Shinkov;A. Borissova;K. Kalinov
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文献类型：
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作者：
Ivayla Uzunova;G. Kirilov;Sabina Zacharieva;A. Shinkov;A. Borissova;K. Kalinov
成人生长激素缺乏症（GHDA）被认为与心血管风险增加有关，最常见的反映是代谢综合征（MS）的患病率。然而，直接比较GHD患者MS患病率与普通人群MS患病率的研究仍然有限。本研究的目的是调查GHD患者队列中MS的个体危险因素，并将其患病率与年龄和性别匹配的对照组进行比较。设计：横断面病例对照研究。方法对54例成人GHD患者（儿童期发病GHD（COGHD）19例，成人期发病GHD（AOGHD）35例）和2153例对照组进行研究。根据2011年内分泌学会临床实践指南的建议诊断GHD，并根据NCEP-ATP III定义对MS进行评分。结果GHD组的主要代谢异常为腰围增加（50.0%）、低HDL胆固醇（42.6%）和高甘油三酯血症（40.7%），其患病率（分别为p=0.013、p=0.019和p=0.010）均显著高于以血压升高为主的对照组（64.2%）（p<0.0001）。然而，两组之间MS患病率的差异（29.6% vs.对照组24.9%）未能达到统计学显著性（p=0.429）。两组MS患者在代谢特征（血压升高除外）、平均年龄和性别分布方面无显著差异。结论：虽然GHDA与内脏肥胖和血脂异常的发生有关，但这些不良心血管危险因素并不能决定保加利亚GHD患者MS的患病率高于对照组。此外，MS的个体风险因素在两组MS患者之间没有显著差异。
OBJECTIVE Growth hormone deficiency in adults (GHDA) is considered to be associated with increased cardiovascular risk, most commonly reflected by the prevalence of the metabolic syndrome (MS). However, there are still a limited number of studies comparing directly the MS prevalence in GHD patients to that in general population. The aim of this study was to investigate the individual risk factors of the MS in a cohort of GHD patients and to compare its prevalence with an age- and sex-matched control group. DESIGN A cross-sectional case-control study. METHODS In total, 54 adult patients with GHD (childhood onset GHD (COGHD): n=19, adult onset GHD (AOGHD): n=35) and 2 153 control subjects were studied. GHD was diagnosed according to the Endocrine Society Clinical Practice Guideline recommendations from 2011 and MS was scored by the NCEP-ATP III definition. RESULTS The main metabolic abnormalities in GHD group were increased waist circumference (50.0%), low HDL-cholesterol (42.6%) and hypertriglyceridemia (40.7%) and their prevalence was significantly higher (p=0.013, p=0.019 and p=0.010, respectively) than in control group, where increased blood pressure prevailed (64.2%, p<0.0001). However, the difference in the MS prevalence between the 2 groups (29.6% vs. 24.9% in controls) failed to reach statistical significance (p=0.429). Patients with MS from both groups did not differ significantly in their metabolic profile (except for increased blood pressure), mean age and gender distribution. CONCLUSIONS Although GHDA was associated with the development of visceral obesity and dyslipidemia, these adverse cardiovascular risk factors did not determine a higher prevalence of the MS in Bulgarian GHD patients compared to control subjects. Furthermore, the individual risk factors of the MS did not significantly differ between patients with MS from both groups.