The Metabolic Risk in Patients Newly Diagnosed with Acromegaly Is Related to Fat Distribution and Circulating Adipokines and Improves after Treatment.

Abstract

BACKGROUND/AIMS:

Adipose tissue (AT) distribution is closely related to metabolic disease risk. Growth hormone (GH) reduces visceral and total body fat mass and induces whole-body insulin resistance. Our aim was to assess the effects of total and visceral AT (VAT) distribution and derived adipokines on systemic insulin resistance and lipid metabolism in acromegaly.

METHODS:

Seventy adult patients with active acromegaly (43 males, age 49 ± 14 years) were evaluated before treatment, and a subset (n = 30, 20 males) was evaluated after treatment for acromegaly. Body composition and VAT, glucose metabolism parameters, lipids, C-reactive protein, and selected adipokines (vaspin, omentin, adiponectin, and leptin) were measured.

RESULTS:

At baseline, VAT was positively associated with glucose metabolism parameters and with lipids. GH, but not IGF-I, was negatively associated with all AT depots (visceral, trunk, limbs, and total; 0.41 ≤ r ≤ 0.61, p < 0.001 for all) and positively associated with vaspin (r = 0.31, p = 0.013). The fat deposition after treatment was predominantly located on trunk and visceral depots. The lipid profile partially improved, with increases in HDL and apolipoprotein A-I and a decrease in lipoprotein(a). Vaspin decreased and omentin increased. Adiponectin and leptin did not change significantly. The improvement in homeostasis model assessment for insulin resistance (HOMA-IR) was best predicted by the decreases in IGF-I and vaspin and the lack of an increase in trunk fat (R2 = 0.59, p = 0.001).

CONCLUSIONS:

(1) VAT is a metabolic risk factor for patients with active acromegaly; (2) vaspin and omentin levels are influenced by the disease activity but are not associated with VAT mass; (3) fat deposition after treatment occurs predominantly on the trunk and in visceral depots, and (4) insulin resistance decreases and the lipid profile partially improves with treatment.

• Authors: Nicoleta C Olarescu, Ansgar Heck, Kristin Godang, Thor Ueland, Jens Bollerslev
• Journal: Neuroendocrinology (Neuroendocrinology) Vol. 103 Issue 3-4 Pg. 197-206 ( 2016) ISSN: 1423-0194 [Electronic] Switzerland
• PMID: 25592241 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 S. Karger AG, Basel.

Chemical References

• Adipokines
• Cytokines
• GPI-Linked Proteins
• ITLN1 protein, human
• Intercellular Signaling Peptides and Proteins
• Lectins
• SERPINA12 protein, human
• Serpins
• Somatostatin
• Insulin-Like Growth Factor I
• C-Reactive Protein
• Glucose

Topics

• Acromegaly (blood, pathology, therapy)
• Adipokines (blood)
• Adult
• Aged
• Body Composition (drug effects)
• C-Reactive Protein (metabolism)
• Cytokines (metabolism)
• Female
• GPI-Linked Proteins (metabolism)
• Glucose (metabolism)
• Homeostasis
• Humans
• Insulin Resistance (physiology)
• Insulin-Like Growth Factor I (metabolism)
• Intercellular Signaling Peptides and Proteins (metabolism)
• Intra-Abdominal Fat (pathology)
• Lectins (metabolism)
• Male
• Metabolic Diseases (etiology)
• Middle Aged
• Serpins (metabolism)
• Somatostatin (analogs & derivatives, therapeutic use)
• Treatment Outcome