Growth Hormone Secretory Capacity Is Associated with Cardiac Morphology and Function in Overweight and Obese Patients: A Controlled, Cross-Sectional Study

Abstract

Obesity is associated with increased cardiovascular morbidity. Adult patients with growth hormone deficiency (GHD) show morpho-functional cardiological alterations. A total of 353 overweight/obese patients are enrolled in the period between 2009 and 2019 to assess the relationships between GH secretory capacity and the metabolic phenotype, cardiovascular risk factors, body composition and cardiac echocardiographic parameters. All patients underwent GHRH + arginine test to evaluate GH secretory capacity, DEXA for body composition assessment and transthoracic echocardiography. Blood samples are also collected for the evaluation of metabolic parameters. In total, 144 patients had GH deficiency and 209 patients had normal GH secretion. In comparing the two groups, we found significant differences in body fat distribution with predominantly visceral adipose tissue accumulation in GHD patients. Metabolic syndrome is more prevalent in the GHD group. In particular, fasting glycemia, triglycerides and systolic and diastolic blood pressure are found to be linearly correlated with GH secretory capacity. Epicardial fat thickness, E/A ratio and indexed ventricular mass are worse in the GHD group. In the population studied, metabolic phenotype, body composition, cardiovascular risk factors and cardiac morphology are found to be related to the GH secretory capacity. GH secretion in the obese patient seems to be an important determinant of metabolic health.

Obesity-Associated Hepatic Steatosis, Somatotropic Axis Impairment, and Ferritin Levels Are Strong Predictors of COVID-19 Severity

“…IGF-1 is a key predictive factor for metabolic alterations in obesity as it represents a mitogenic hormone involved in processes like growth, angiogenesis, and differentiation [ 51 ]. In individuals with obesity, lower IGF-1 serum levels and a blunted response to GH-stimulating dynamic tests are associated with more significant metabolic impairment and even morpho-functional cardiological alterations [ 52 ]. Higher serum IGF-1 in obese patients correlates with lower inflammatory patterns and better skeletal health [ 53 ].…”

Obesity-Associated Hepatic Steatosis, Somatotropic Axis Impairment and Ferritin Levels are Strong Predictors of COVID-19 Severity

“…IGF-1 is a key predictive factor for metabolic alterations in obesity as it represents a mitogenic hormone involved in processes like growth, angiogenesis, and differentiation [50]. In individuals with obesity, lower IGF-1 serum levels and a blunted response to GHstimulating dynamic tests are associated with more significant metabolic impairment and even morpho-functional cardiological alterations [51]. Higher serum IGF-1 in obese patients correlates with lower inflammatory patterns and better skeletal health [52].…”

Weight Loss and Sleep, Current Evidence in Animal Models and Humans

“…On the other hand, GH is typically elevated at the onset of sleep, with the highest levels during SWS and starts to decline during the fourth decade of life [158]. Growth hormone deficiency has been linked with an increase in fat accumulation in adults [159,160], and some studies reported an increase in hepatic steatosis, even though the results are not univocal [161].…”