Growth hormone deficiency by growth hormone releasing hormone-arginine testing criteria predicts increased cardiovascular risk markers in normal young overweight and obese women.
BACKGROUND
Little is known about the relationship between GH and cardiovascular risk markers in women without organic hypothalamic/pituitary disease.


OBJECTIVE
The objective of the study was to determine whether healthy young overweight and obese women, who would be classified as having GH deficiency (GHD) based on standard criteria used in hypopituitarism (peak GH after stimulation with GHRH and arginine < 5 ng/ml), have increased cardiovascular risk markers.


METHODS
This was a cross-sectional study.


METHODS
The study was conducted at the General Clinical Research Center.


METHODS
Forty-five women of reproductive age, mean age 33.1 +/- 1.2 yr and mean body mass index (BMI) 30.9 +/- 1.0 kg/m(2).


METHODS
There was no intervention.


METHODS
Measures included carotid intima-medial thickness, high-sensitivity C-reactive protein (hsCRP), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein, triglycerides, E-selectin, soluble intercellular adhesion molecule-1, TNF-alpha receptor I, TNF-alpha receptor II, fasting insulin levels, and oral glucose tolerance testing.


RESULTS
Twenty-six percent of overweight or obese subjects and none with BMI less than 25 kg/m(2) met criteria for GHD. Subjects who met GHD criteria had a mean BMI of 37.0 +/- 1.7 kg/m(2) (range 28.6-43.6 kg/m(2)), and their mean waist circumference (110.1 +/- 3.5 cm) was higher than in overweight/obese women with GH sufficiency (P = 0.007). Mean carotid intima-media thickness, hsCRP, soluble intercellular adhesion molecule-1, TNF-alpha receptor I, and TNF-alpha receptor II levels were higher, and HDL lower, in women meeting GHD criteria than in GH sufficiency. Differences in HDL, hsCRP, and TNF-alpha receptor II remained after controlling for age plus BMI, waist circumference, or trunk fat. There were no differences in measures of insulin resistance.


CONCLUSIONS
There may be a relative GHD syndrome in overweight and obese women without organic pituitary or hypothalamic disease that confers increased cardiovascular risk, independent of weight.
Utz
Andrea L
AL
Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.
Yamamoto
Ami
A
Hemphill
Linda
L
Miller
Karen K
KK
D000328:Adult; D001120:Arginine; D015415:Biomarkers; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D013007:Growth Hormone-Releasing Hormone; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D007333:Insulin Resistance; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood
D015415:Biomarkers; D008076:Cholesterol, HDL; D047889:Receptors, Tumor Necrosis Factor, Type II; D019382:Human Growth Hormone; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D013007:Growth Hormone-Releasing Hormone; D001120:Arginine