Metabolic Profile and Echocardiographic Evaluation in Adults with Growth Hormone Deficiency
Metabolic Profile and Echocardiographic Evaluation in Adults with Growth Hormone Deficiency
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DOI：
10.1055/a-1941-8556
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发表时间：
2022-06
影响因子：
2.2
通讯作者：
Hongbo Yang;Hanyuan Xu;Linjie Wang;Lian Duan;F. Gong;Huijuan Zhu;H. Pan
中科院分区：
文献类型：
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作者：
Hongbo Yang;Hanyuan Xu;Linjie Wang;Lian Duan;F. Gong;Huijuan Zhu;H. Pan
成人生长激素缺乏症（AGHD）与心血管风险增加有关。这项回顾性队列研究的主要终点是比较儿童期发病（CO）和成年期发病（AO） AGHD患者的代谢谱和超声心动图参数。共纳入26例CO型AGHD患者（男性19例，26.8±8.5岁）和41例AO型AGHD患者（男性23例，35.1±6.8岁）。比较两组胰岛素样生长因子-1 （IGF-1 SDS）的标准差评分、代谢谱、肝脏超声及超声心动图参数。IGF-1 SDS在CO AGHD患者中显著降低（p<0.05）。AO AGHD患者表现出严重的糖脂异常，c反应蛋白水平升高（p=0.012），非酒精性脂肪性肝病的比例较高（95.2%比8.3%,p<0.001）。在所有受试者中，IGF-1 SDS与低密度脂蛋白胆固醇呈负相关，与总胆固醇和脂蛋白a （Lpa）呈正相关。两组间IGF-1 SDS与高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、LPa、尿酸、肌酐的相关性差异有统计学意义（交互作用均p <0.05）。与AO AGHD患者相比，CO AGHD患者表现出较小的心脏，但心室射血分数相似。根据发病年龄，AGHD可能是一组异质性实体。AO患者有明显的代谢紊乱，而CO患者心脏较小，但心脏性能相似。生长激素替代疗法是否对CO和AO AGHD患者同样有益还需要进一步的研究。
Abstract Adult growth hormone deficiency (AGHD) is associated with increased cardiovascular risks. The primary endpoint of this retrospective cohort study was to compare metabolic profile and echocardiographic parameters in childhood-onset (CO) and adulthood-onset (AO) AGHD patients. 26 patients with CO AGHD (19 males, 26.8±8.5 years) and 41 patients with AO AGHD (23 males, 35.1±6.8 years) were included. The standard deviation score of insulin-like growth factor-1 (IGF-1 SDS), metabolic profile, liver sonography and echocardiographic parameters were compared. The IGF-1 SDS were significantly lower in CO AGHD patients (p<0.05). AO AGHD patients showed much profound glycolipid aberrations, elevated C-reactive protein levels (p=0.012), and proportionally higher prevalence of non-alcoholic fatty liver disease (95.2% vs.8.3%, p<0.001). In all subjects, IGF-1 SDS was negatively related to low-density lipoprotein cholesterol, and positively related to total cholesterol and lipoprotein a (Lpa). There were significant differences between the two group with regard to the correlations between IGF-1 SDS and high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, LPa, uric acid and creatinine (all p for interaction<0.05). CO AGHD patients exhibited smaller heart, but similar ventricular ejection fraction compared to AO AGHD patients. AGHD may be a group of heterogenous entity based on the onset ages of disease. AO patients had prominent metabolic disorders, while CO patients had smaller heart but similar cardiac performance. Whether growth hormone replacement therapy will equally benefit both CO and AO AGHD patients needs further investigations.