title: Hypopituitarsim is associated with triglyceride enrichment of very low-density lipoprotein.
abstract: The dyslipidemia associated with hypopituitarism may contribute to increased vascular mortality. The atherogenic potential of lipoproteins is determined not only by concentration but also by their composition. We therefore studied very low-density lipoprotein composition and apolipoprotein B kinetics in 16 hypopituitary subjects and 16 controls. Hypopituitarism was associated with reduced high-density lipoprotein cholesterol (0.98[0.82-1.18] vs. 1.35[1.15-1.41] mmol/liter, P < 0.001) and increased triglyceride concentrations (1.64[1.09-2.77] vs. 1.12[0.66-1.67] mmol/liter, P = 0.01). Total (P = 0.76) and low-density lipoprotein cholesterol (P = 0.56) concentrations were similar. Very low-density lipoprotein- triglyceride was significantly increased (1.48[1.02-2.55] vs. 0.9[0.31-2.30] mmol/liter, P = 0.004), but very low-density lipoprotein cholesterol levels were similar (P = 0.93). The molar ratios of very low-density lipoprotein-triglyceride:apolipoprotein B (6193[4283-9566] vs. 3599[3188-6854], P = 0.005) and very low-density lipoprotein-triglyceride:cholesterol (2.8[1.98-3.78] vs. 1.6[1.44-2.80], P < 0.003) were significantly increased; very low-density lipoprotein-cholesterol:apolipoprotein B molar ratios (P = 0.93) were similar. Very low-density lipoprotein apolipoprotein B fractional synthetic rate (a measure of apolipoprotein B catabolism, P = 0.42) and pool size (P = 0.63) were similar. The very low-density lipoprotein apolipoprotein B absolute synthetic rate (a measure of apolipoprotein B synthesis) tended to be higher in hypopituitarism (17.7[2.91-19.50] vs. 26.6[19.64-28.05] mg/kg per day, P = 0.24) but failed to reach statistical significance. The absolute synthetic rate, and hence very low-density lipoprotein production, correlated with very low-density lipoprotein triglyceride:apolipoprotein B ratio (P = 0.02, Rs = 0.63), suggesting that triglyceride enrichment of very low-density lipoprotein is important in the mechanism underlying very low-density lipoprotein overproduction in hypopituitarism. Because triglyceride-enriched lipoproteins are proatherogenic, this may contribute to the vascular mortality observed in hypopituitarism. The reasons for these observations are unknown; GH deficiency or routine endocrine replacement may be important.
authors.affiliation: Department of Metabolic Medicine, St. Mary's Hospital, Imperial College of Science, Technology, and Medicine, Paddington, London, United Kingdom. t.kearney@ic.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Kearney
authors.forename: C
authors.initials: C
authors.lastname: Navas de Gallegos
authors.forename: A
authors.initials: A
authors.lastname: Chrisoulidou
authors.forename: R
authors.initials: R
authors.lastname: Gray
authors.forename: P
authors.initials: P
authors.lastname: Bannister
authors.forename: S
authors.initials: S
authors.lastname: Venkatesan
authors.forename: D G
authors.initials: DG
authors.lastname: Johnston
mesh_terms: D000236:Adenoma / Q000097:blood; D000328:Adult; D000368:Aged; D053299:Apolipoprotein B-100; D001055:Apolipoproteins B / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D015243:Cholesterol, VLDL / Q000097:blood; D003397:Craniopharyngioma / Q000097:blood; D003480:Cushing Syndrome / Q000097:blood; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D020249:Hormone Replacement Therapy; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007018:Hypopituitarism / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D008079:Lipoproteins, VLDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood* / Q000188:drug therapy; D015175:Prolactinoma / Q000097:blood; D012016:Reference Values; D014280:Triglycerides / Q000097:blood*
chemical_list: D053299:Apolipoprotein B-100; D001055:Apolipoproteins B; D001786:Blood Glucose; D008076:Cholesterol, HDL; D015243:Cholesterol, VLDL; D005230:Fatty Acids, Nonesterified; D008079:Lipoproteins, VLDL; D014280:Triglycerides; C030106:very low density lipoprotein triglyceride; D019382:Human Growth Hormone; D002784:Cholesterol