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Alteration of the growth hormone axis, visceral fat dysfunction, and early cardiometabolic risk in adults: the role of the visceral adiposity index

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Abstract

The aim of the study is to clarify the relationship between adipose tissue dysfunction, metabolic profile and growth hormone (GH)/insulin-like growth factor (IGF)-I secretion in healthy adult subjects. We investigated the metabolic profile in a cohort of 231 consecutive healthy subjects in relation to GH, IGF-I levels, and visceral adiposity index (VAI). Anthropometric measures, lipid profile, and glucose and insulin levels during oral glucose tolerance test, Homa-IR and ISI Matsuda, IGF-I and GH peak after GHRH plus Arginine test were analyzed. The subjects with high VAI showed lower GH peak (22.8 ± 11.1 vs. 42.2 ± 21.3 µg/L; p = 0.049) and lower IGF-I (presented as IGF-I under normal range, UNR) (0.54 ± 0.14 vs. 0.64 ± 0.12; p = 0.005) than group with normal VAI. ROC curve analysis identified the cut-off, able to detect subjects with high VAI, i.e., 31.8 µg/L for GH peak and 0.63 for IGF-1 UNR. The subjects with GH peak and IGF-I UNR under the cut-off showed significantly higher levels of VAI, systolic and diastolic blood pressure, glucose and insulin levels, Homa-IR, and lower ISI Matsuda, with a concomitant worse lipid profile (all p < 0.001). A strong relationship between GH axis, VAI and metabolic risk has been demonstrated. A percentage of apparently healthy subjects show a degree of visceral adipose dysfunction associated with GH and IGF-I levels that do not meet the criteria of overt GH deficiency (GHD). Long-term prospective studies could help to clarify and confirm whether a hypothetical condition of subclinical GHD could be taken into account as a new clinical entity.

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Authors and Affiliations

  1. IRCCS SDN, Napoli Via Gianturco 113, 80143, Naples, Italy

    Carolina Di Somma

  2. Section of Endocrinology, Diabetology and Metabolism, Biomedical Department of Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Piazza delle Cliniche 2, 90127, Palermo, Italy

    Alessandro Ciresi, Marco C. Amato & Carla Giordano

  3. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università “Federico II”di Napoli, Via S. Pansini 5, 80131, Naples, Italy

    Silvia Savastano, Elisabetta Scarano & Annamaria Colao

  4. Centro Direzionale Napoli, IOS & Coleman S.r.l, Naples, Italy

    Maria Cristina Savanelli

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Di Somma, C., Ciresi, A., Amato, M.C. et al. Alteration of the growth hormone axis, visceral fat dysfunction, and early cardiometabolic risk in adults: the role of the visceral adiposity index. Endocrine 49, 492–502 (2015). https://doi.org/10.1007/s12020-014-0471-z

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