The visceral adiposity index is associated with insulin sensitivity and IGF-I levels in adults with growth hormone deficiency

Abstract

The visceral adiposity index, based on anthropometric and metabolic parameters, has been shown to be related to adipose tissue function and insulin sensitivity. We aimed to evaluate the performance of the visceral adiposity index in adult patients with growth hormone deficiency. We enrolled 52 patients(mean age 51 ± 13 years) with newly diagnosed growth hormone deficiency and 50 matched healthy subjects as controls at baseline. At baseline and after 12 and 24 months of treatment we evaluated anthropometric measures, lipid profile, glucose and insulin during an oral glucose tolerance test, hemoglobin A1c, homeostasis model assessment estimate of insulin resistance, quantitative insulin sensitivity check index, insulin sensitivity index Matsuda, insulin-like growth factor-I and visceral adiposity index. At baseline growth hormone deficiency patients showed higher waist circumference (p < 0.001), low-density lipoprotein cholesterol (p < 0.001) and visceral adiposity index (p = 0.003) with lower insulin sensitivity index (p = 0.007) and high-density lipoprotein cholesterol (p = 0.001) than controls. During growth hormone treatment we observed a significant increase in insulin-like growth factor-I (p < 0.001), high-density lipoprotein (p < 0.001) with a trend toward increase in insulin sensitivity index (p = 0.055) and a significant decrease in total cholesterol (p < 0.001) and visceral adiposity index (p < 0.001), while no significant changes were observed in other clinical and metabolic parameters. The visceral adiposity index was the only parameter that significantly correlated with growth hormone peak at diagnosis (p < 0.001) and with insulin-like growth factor-I and insulin sensitivity index both at diagnosis (p = 0.009 and p < 0.001) and after 12 (p = 0.026 and p = 0.001) and 24 months (p < 0.001 and p = 0.001) of treatment. The visceral adiposity index, which has shown to be associated with both insulin-like growth factor-I and insulin sensitivity, proved to be the most reliable index of metabolic perturbation, among the most common indexes of adiposity assessment and a marker of benefit during treatment in adult growth hormone deficiency patients.

Glucose Metabolism in Children With Growth Hormone Deficiency

“…These data contrast with those of Radetti et al, who through evaluation of QUICKI demonstrated a slight degree of insulin resistance in GHD children at baseline compared with controls ( 57 ), while other studies did not show any impairment in Homa-IR ( 12 , 27 , 30 , 58 – 61 ) or in ISI ( 38 , 62 – 65 ) in naïve children. No significant difference in fasting glucose, insulin, and HbA1c levels between GHD children and controls were found in many other studies ( 38 , 61 – 70 ).…”

Lipid Accumulation Product, Visceral Adiposity Index, And Chinese Visceral Adiposity Index As Markers Of Cardiometabolic Risk In Adult Growth Hormone Deficiency Patients: A Cross-Sectional Study

“…Clinical evidence suggests that lower GH levels are associated with a deterioration of body composition, which may explain some of the changes observed in AGHD patients. These results highlight the fact that AGHD should be considered as more than a condition lacking GH; it also involves several metabolic disturbances as previously suggested (22).…”

Relationship between IGF-I Concentration and Metabolic Profile in Children with Growth Hormone Deficiency: The Influence of Children’s Nutritional State as well as the Ghrelin, Leptin, Adiponectin, and Resistin Serum Concentrations

“…It is well known that adult patients with GHD show a tendency towards metabolic disorders (higher body mass, unfavourable lipids, and increased leptin and insulin concentrations) and that they return to normal levels following GH treatment [28, 29]. However, the metabolic profile of untreated children with GHD varies in individual reports [4–8].…”

“…It seemed to us that those individuals with GHD who have the lowest bioavailability of IGF-I should present the most severe GHD symptoms. In adults with GHD, strong negative correlations between GH peak concentration and visceral adiposity index (VAI), as well as between IGF-I level and VAI have been proved [29]. VAI takes into account such parameters as BMI and waist circumference, as well as both triglyceride and HDL-cholesterol concentrations.…”