ECE2007 Poster Presentations (1) (659 abstracts)
1Integrated Department of Medicine, Endocrinology, Metabolism and Geriatrics, University of Modena and Reggio Emilia, Modena, Italy; 2Laboratory of Endocrinology, Policlinico of Modena, Modena, Italy; 3Department of Medicine and Medical Specialties, Clinics of Infective Diseases, University of Modena and Reggio Emilia, Modena, Italy.
Introduction: Patients with human immunodeficiency virus-1 (HIV-1) infection develop a lipodystrophic syndrome characterised by accumulation of central fat both in visceral and in subcutaneous compartment. In recent studies approximately 20% of male patients with HIV-related lipodystrophy presented an inadequate peak of GH secretion in response to GHRH-arginine testing, which is strongly inversely related to visceral adipose tissue-(VAT).
Aim of the study: To investigate GH secretion in female patients with HIV-related lipodystrophy according to their body composition.
Subjects and methods: We included 35 HIV-infected female patients (mean age 44.6±7.6 S.D.) with lipodystrophy according to the Marrakech scale. We investigated their GH response to standardised GHRH-arginine testing in order to compare it with BMI, VAT and subcutaneous adipose tissue (SAT) evaluated by CT scan. On the basis of current clinical guidelines we considered a severely impaired GH secretion (IGHS) when the GH peak after GHRH-arginine testing was ≤5 μg/L; a mildly IGHS when it was >5 μg/L but <9 μg/L and a normal GH secretion with a peak ≥9 μg/L, according to the degree of obesity together with preliminary data obtained in male HIV-related lipodystrophy.
Results: The 37.5% of our patients had IGHS (12.5% a severe IGHS, 25% the mild form). The average GH peak in the three group and the compared data among them are shown in the table:
IGHS | GH peak | IGF-1 | IGFBP3 | BMI | VAT cm2 | SAT cm2 | VAT/SAT |
Severe | 3.2+1.6 | 112.8+23.5 | 1682.5±606.1 | 27.1±6.6 | 102.3±66.7 | 154±46 | 0.66±0.32 |
Mild | 6.5+0.9 | 157+67.9 | 2149.3±650.2 | 25.9±3.1 | 119.8±70.4 | 307.2±132.8 | 0.43±0.22 |
Normal | 21.5+8.1 | 183.9+84.6 | 2144.4±639 | 26.1±2.4 | 106.7±45.1 | 215.8±93.6 | 0.57±0.29 |
Conclusion: The pituitary GH secretion may be impaired in HIV-positive women. The percentage of subjects with IGHS seems to be higher in HIV-positive women than in men. IGF-1 results lower in IGHS subjects. Furthermore, body composition does not change according to GH-peak status.