Increased Serum High-Sensitivity C-Reactive Protein in Growth Hormone-Deficient Patients With Non-Functioning Pituitary Tumors
Increased Serum High-Sensitivity C-Reactive Protein in Growth Hormone-Deficient Patients With Non-Functioning Pituitary Tumors
复制标题
在生长激素缺陷型垂体肿瘤的患者中，血清高敏性C反应蛋白增加
DOI：
10.1210/jendso/bvab048.1315
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发表时间：
2021-05-03
影响因子：
4.1
通讯作者：
Ichihara A
中科院分区：
文献类型：
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作者：
Seki Y;Ichihara A
简介：生长激素（GH）缺乏是与垂体瘤并发的最常见的激素缺乏，与较高的死亡率和心血管事件相关。据报道，通过高敏 C 反应蛋白 (hs-CRP) 测量的炎症与心血管事件相关。然而，hs-CRP 与 GH 缺乏之间的关联仍不清楚。我们回顾性评估了无功能垂体瘤 (NFPT) 患者血清 hs-CRP 水平与 GH 分泌之间的关联。方法：在这项回顾性研究中，纳入了 2013 年至 2016 年接受 GH 释放肽 2 (GHRP-2) 测试的无功能垂体腺瘤 (NFPA) 和 Rathke 囊肿的成年患者。有垂体手术或放射史或估计 GFR 低于 30 mL/min/1.73m2 的患者被排除。结果：81 名患者（70 名 NFPA 和 11 名 Rathke 囊肿）中，44% 通过 GHRP-2 检测诊断为严重 GH 缺乏症。男性患者（P = 0.001）和经常饮酒的患者（P = 0.011）血清hs-CRP水平显着较高，并且与BMI（r = 0.35，P = 0.002）、肌酐（r = 0.41，P < 0.001）、eGFR（r = -0.29，P = 0.009）、峰值GH反应显着相关至 GHRP-2（r = -0.48，P < 0.001)、AST (r = 0.32，P = 0.004)、ALT (r = 0.34，P = 0.002)、γGTP (r = 0.41，P < 0.001)、HDL 胆固醇 (r = -0.33，P = 0.003) 和甘油三酯 (r = 0.25，P = 0.02）。吸烟习惯（P = 0.084）、年龄（r = 0.18，P = 0.10）、LDL-胆固醇（r = 0.16，P = 0.15）、IGF-1（r = -0.14，P = 0.23）和IGF-1 SD评分（r = -0.11，P = 0.32）与血清hs-CRP水平无显着相关性。调整年龄、性别、BMI、定期饮酒以及血清肌酐、γGTP 和 HDL-胆固醇水平后，对 GHRP-2 的 GH 峰值反应（β = -0.24，P = 0.024）是确定血清 hs-CRP 水平的重要变量。结论：GH 缺乏的 NFPT 患者血清 hs-CRP 水平升高提示 GH 缺乏对心血管疾病相关炎症的发病机制有贡献。
Introduction: Growth hormone (GH) deficiency, the most common hormone deficit complicated with pituitary tumors, is associated with higher mortality and cardiovascular events. Inflammation, as measured by high-sensitivity C-reactive protein (hs-CRP), has been reported to be associated with cardiovascular events. However, the association between hs-CRP and GH deficiency is still unknown. We retrospectively evaluated the association between serum hs-CRP levels and GH secretion in patients with non-functioning pituitary tumors (NFPTs). Methods: In this retrospective study, adult patients with non-functioning pituitary adenoma (NFPA) and Rathke’s cyst who received a GH-releasing pepitide-2 (GHRP-2) test from 2013 until 2016 were included. Patients with a history of pituitary surgery or radiation, or estimated GFR lower than 30 mL/min/1.73m2 were excluded. Results: Of 81 patients (70 NFPA and 11 Rathke’s cyst), 44% were diagnosed as severe GH deficiency by GHRP-2 test. Serum hs-CRP level was significantly higher in the male patients (P = 0.001) and the patients with regularly alcohol intake (P = 0.011) and was significantly correlated with BMI (r = 0.35, P = 0.002), creatinine (r = 0.41, P < 0.001), eGFR (r = -0.29, P = 0.009), peak GH response to GHRP-2 (r = -0.48, P < 0.001), AST (r = 0.32, P = 0.004), ALT (r = 0.34, P = 0.002), γGTP (r = 0.41, P < 0.001), HDL-cholesterol (r = -0.33, P = 0.003) and triglyceride (r = 0.25, P = 0.02). Smoking habit (P = 0.084), age (r = 0.18, P = 0.10), LDL-cholesterol (r = 0.16, P = 0.15), IGF-1 (r = -0.14, P = 0.23) and IGF-1 SD score (r = -0.11, P = 0.32) were not significantly correlated with serum hs-CRP level. Peak GH response to GHRP-2 (β = -0.24, P = 0.024) was a significant variable to determine serum hs-CRP level after adjustment for age, sex, BMI, regularly alcohol intake and serum creatinine, γGTP and HDL-cholesterol levels. Conclusion: Increased serum hs-CRP levels in the GH-deficient patients with NFPTs suggested the contribution of GH deficiency to pathogenesis of inflammation associated with cardiovascular diseases.