Prospective Study of Surgical Treatment of Acromegaly: Effects on Ghrelin, Weight, Adiposity, and Markers of CV Risk

Reyes-Vidal, Carlos; Fernandez, Jean Carlos; Bruce, Jeffrey N.; Crisman, Celina; Conwell, Irene M.; Kostadinov, Jane; Geer, Eliza B.; Post, Kalmon D.; Freda, Pamela U.

doi:10.1210/jc.2014-2259

Cited by 46 publications

(52 citation statements)

References 47 publications

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“…We found, as have others, lower leptin levels in active acromegaly (7,40,41). Our data suggest that observed leptin changes are due primarily to fat mass changes, but are also influenced by leptin’s known sexual dimorphism (7,40,42); in multivariate analysis, gender and fat mass remained significant predictors of leptin levels.…”

Section: Discussionsupporting

confidence: 91%

“…Our data suggest that observed leptin changes are due primarily to fat mass changes, but are also influenced by leptin’s known sexual dimorphism (7,40,42); in multivariate analysis, gender and fat mass remained significant predictors of leptin levels. In prior studies leptin correlated with fat mass (41), but we found this highly significant only in men.…”

Section: Discussionmentioning

confidence: 62%

“…IGF-I levels were compared to age-appropriate normal ranges. Glucose was measured by hexokinase method, leptin by human RIA kit (Millipore, Research, St. Charles, MO) and lipids as previously described (7). Samples were run in duplicate.…”

Section: Methodsmentioning

confidence: 99%

“…Mass of lean tissue and fat for the whole body and specific regions was provided by the software. We calculated DXA estimated inter-muscular adipose tissue-free skeletal muscle (SM) mass (IMAT-free SM or SM E ) based on a prediction equation previously validated and found to agree highly with total body SM mass by MRI in a variety of patients, including acromegaly (7,11). …”

Section: Methodsmentioning

confidence: 99%

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IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

et al. 2015

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Purpose Activity of acromegaly is gauged by levels of GH and IGF-1 and epidemiological studies demonstrate that their normalization reduces acromegaly’s excess mortality rate. However, few data are available linking IGF-1 levels to features of the disease that may relate to cardiovascular (CV) risk. Therefore, we tested the hypothesis that serum IGF-1 levels relative to the upper normal limit relate to insulin sensitivity, serum CV risk markers and body composition in acromegaly. Methods In this prospective, cross-sectional study conducted at a pituitary tumor referral center we studied 138 adult acromegaly patients, newly diagnosed and previously treated surgically, with fasting and post-oral glucose levels of endocrine and CV risk markers and body composition assessed by DXA. Results Active acromegaly is associated with lower insulin sensitivity, body fat and CRP levels than acromegaly in remission. %ULN IGF-1 strongly predicts insulin sensitivity, better than GH and this persists after adjustment for body fat and lean tissue mass. %ULN IGF-1 also relates inversely to CRP levels and fat mass, positively to lean tissue and skeletal muscle estimated (SME) by DXA, but not to blood pressure, lipids, BMI or waist circumference (WC). Gender interacts with the IGF-1-lean tissue mass relationship. Conclusions Active acromegaly presents a unique combination of features associated with CV risk, reduced insulin sensitivity yet lower body fat and lower levels of some serum CV risk markers, a pattern that is reversed in remission. %ULN IGF-1 levels strongly predict these features. Given the known increased CV risk of active acromegaly, these findings suggest that of these factors insulin resistance is most strongly related to disease activity and potentially to the increased CV risk of active acromegaly.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

et al. 2015

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“…In doing this, we attempted to investigate the specific role of acromegaly in the development of atherosclerosis in patients with acromegaly. On the other hand, in a recent study, Reyes-Vidal et al [28] revealed that some cardiovascular risk factors, including body weight and waist circumference, were increased when remission was achieved in acromegaly. In our study, waist circumference in the AA group was higher than the CA group; however, this difference was not statistically significant.…”

Section: Discussionmentioning

confidence: 95%

Markers of early atherosclerosis, oxidative stress and inflammation in patients with acromegaly

et al. 2014

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Impact of Growth Hormone on Regulation of Adipose Tissue

Troike

Henry

Jensen

et al. 2017

Comprehensive Physiology

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Increasing prevalence of obesity and obesity-related conditions worldwide has necessitated a more thorough understanding of adipose tissue (AT) and expanded the scope of research in this field. AT is now understood to be far more complex and dynamic than previously thought, which has also fueled research to reevaluate how hormones, such as growth hormone (GH), alter the tissue. In this review, we will introduce properties of AT important for understanding how GH alters the tissue, such as anatomical location of depots and adipokine output. We will provide an overview of GH structure and function and define several human conditions and cognate mouse lines with extremes in GH action that have helped shape our understanding of GH and AT. A detailed discussion of the GH/AT relationship will be included that addresses adipokine production, immune cell populations, lipid metabolism, senescence, differentiation, and fibrosis, as well as brown AT and beiging of white AT. A brief overview of how GH levels are altered in an obese state, and the efficacy of GH as a therapeutic option to manage obesity will be given. As we will reveal, the effects of GH on AT are numerous, dynamic and depot-dependent. © 2017 American Physiological Society. Compr Physiol 7:819-840, 2017.

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Prospective Study of Surgical Treatment of Acromegaly: Effects on Ghrelin, Weight, Adiposity, and Markers of CV Risk

Cited by 46 publications

References 47 publications

IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

IGF-1 levels across the spectrum of normal to elevated in acromegaly: relationship to insulin sensitivity, markers of cardiovascular risk and body composition

Markers of early atherosclerosis, oxidative stress and inflammation in patients with acromegaly

Impact of Growth Hormone on Regulation of Adipose Tissue

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