title: Adipose Tissue Redistribution and Ectopic Lipid Deposition in Active Acromegaly and Effects of Surgical Treatment.
abstract: BACKGROUND
  GH and IGF-I have important roles in the maintenance of substrate metabolism and body composition. However, when in excess in acromegaly, the lipolytic and insulin antagonistic effects of GH may alter adipose tissue (AT) deposition.
  
  
  OBJECTIVE
  The purpose of this study was to examine the effect of surgery for acromegaly on AT distribution and ectopic lipid deposition in liver and muscle.
  
  
  METHODS
  This was a prospective study before and up to 2 years after pituitary surgery.
  
  
  METHODS
  The setting was an academic pituitary center.
  
  
  METHODS
  Participants were 23 patients with newly diagnosed, untreated acromegaly.
  
  
  METHODS
  We determined visceral (VAT), subcutaneous (SAT), and intermuscular adipose tissue (IMAT), and skeletal muscle compartments by total-body magnetic resonance imaging, intrahepatic and intramyocellular lipid by proton magnetic resonance spectroscopy, and serum endocrine, metabolic, and cardiovascular risk markers.
  
  
  RESULTS
  VAT and SAT masses were lower than predicted in active acromegaly, but increased after surgery in male and female subjects along with lowering of GH, IGF-I, and insulin resistance. VAT and SAT increased to a greater extent in men than in women. Skeletal muscle mass decreased in men. IMAT was higher in active acromegaly and decreased in women after surgery. Intrahepatic lipid increased, but intramyocellular lipid did not change after surgery.
  
  
  CONCLUSIONS
  Acromegaly may present a unique type of lipodystrophy characterized by reduced storage of AT in central depots and a shift of excess lipid to IMAT. After surgery, this pattern partially reverses, but differentially in men and women. These findings have implications for understanding the role of GH in body composition and metabolic risk in acromegaly and other clinical settings of GH use.
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Reyes-Vidal
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Hamed
authors.initials: H
authors.lastname: Mojahed
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Wei
authors.initials: W
authors.lastname: Shen
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Zhezhen
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arias-Mendoza
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Jean Carlos
authors.initials: JC
authors.lastname: Fernandez
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Dympna
authors.initials: D
authors.lastname: Gallagher
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Jeffrey N
authors.initials: JN
authors.lastname: Bruce
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Kalmon D
authors.initials: KD
authors.lastname: Post
authors.affiliation: Departments of Medicine (C.M.R.-V., W.S., J.C.F., D.G., P.U.F.), Radiology (H.M., F.A.-M.), Biostatistics (Z.J.), and Neurosurgery (J.N.B.), Columbia University, College of Physicians & Surgeons, New York, New York 10032; and Departments of Medicine and Neurosurgery (K.D.P.), Mt. Sinai School of Medicine, New York, New York 10029.
authors.forename: Pamela U
authors.initials: PU
authors.lastname: Freda
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D000236:Adenoma / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D000273:Adipose Tissue / Q000378:metabolism* / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D050218:Body Fat Distribution; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D006801:Humans; D008060:Lipodystrophy / Q000209:etiology / Q000378:metabolism* / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult