ICEECE2012 Poster Presentations Pituitary Clinical (183 abstracts)
Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.Mi.S), University of Palermo, Palermo, Italy.
Background: The Visceral Adiposity Index (VAI) has been suggested as a new gender-specific marker of visceral adipose dysfunction, strongly associated with insulin sensitivity in patients with cardio-metabolic risk.
Aim: To test VAI in active acromegaly for the assessment of disease-associated metabolic risk evaluating its association with hormonal data, adipocytokine levels, insulin sensitivity and secretion parameters in a cohort of 27 subjects (15 M, 12 F, mean age 54.9 years).
Methods: Glucose, HbA1c, nadir and AUC of GH during OGTT, AUC of C-peptide (CP) during a mixed-meal tolerance test (MMTT), M value during an euglycemic hyperinsulinemic clamp, leptin, adiponectin, TNF-α, IL-6 were evaluated in newly diagnosed patients grouped into those with normal (Group A, No 15; 55.5%) and high VAI (Group B, No 12; 44.5%).
Results: VAI value was positively correlated with age of patients (P=0.048), basal, nadir and AUC of GH (P=0.001, 0.007 and 0.002, respectively), IGF1 (P=0.001), TNF-α (P=0.010) and negatively with adiponectin (P<0.001). Group B showed 1) significantly higher levels of basal GH (P=0.018), AUCGH (P=0.047), IGF1 (P=0.047) and AUCCP (P=0.018); 2) significantly lower M value (P<0.001) and adiponectin levels (P<0.001); 3) higher prevalence of systolic blood pressure (P=0.006) and impaired glucose tolerance (P=0.001).
Conclusions: In active acromegaly, VAI appears to be independently associated with hormonal parameters, insulin sensitivity and secretion indexes, adiponectin and TNF-α levels. Therefore, VAI could be used as a new easy tool in daily clinical practice for the assessment of metabolic risk associated with active acromegaly.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
Acromegalic patients with normal VAI (Group A) No 15 (55.5%) | Acromegalic patients with high VAI (Group B) No 12 (44.5%) | P | |
Basal GH (μg/l) | 3.3 (1.209.70) | 32 (3.1036) | 0.018 |
Nadir GH (μg/l) | 5.50 (28.80) | 19 (2.1035) | 0.082 |
AUCGH | 763 (345997) | 3700 (5254230) | 0.047 |
IGF1 (ULN) | 1.61 (1.032.16) | 2.40 (1.403.50) | 0.047 |
Fasting glucose (mmol/l) | 6.16 (5.586.49) | 5.94 (4.726.33) | 0.082 |
M value (CLAMP) | 3.30 (3.144) | 1.65 (1.422.70) | <0.001 |
AUCCP (MMTT) | 351 (279421) | 769 (331821) | 0.018 |
HbA1c (%) | 5.8 (5.455.90) | 5.70 (5.106.70) | 0.392 |
Leptin (ng/ml) | 4.80 (2.8018.45) | 6.10 (2.409.60) | 0.865 |
Adiponectin (μg/ml) | 10.50 (9.1015.95) | 4 (3.407.20) | <0.001 |
TNF-α (ng/ml) | 1.30 (1.053.05) | 3.30 (1.104) | 0.082 |
IL-6 (pg/ml) | 1.72 (1.352.07) | 1.48 (1.061.80) | 0.252 |