Reduced peak stimulated growth hormone is associated with hyperuricemia in obese children and adolescents

Abstract

The purpose of the study is to investigate whether reduced peak GH response to arginine-levodopa test is associated with hyperuricemia in obese children and adolescents. The study population consisted of a total sample of 78 obese and 30 normal-weight children and adolescents without known hypopituitarism. All participants underwent clinical examination and GH stimulation testing. IGF-1, lipid profile and other metabolic markers were assessed. The obese subjects were then divided into two groups according to the serum levels of uric acid. Results show that obese subjects had significantly lower peak GH, lower IGF-1 and similar height SDS than those in the control group. Children with hyperuricemia had significantly lower peak stimulated GH compared with non-hyperuricemia obese subjects. Results from logistic regression model showed that peak GH were negatively associated with hyperuricemia after controlling for age, gender, tanner stage, BMI SDS, IGF-1, blood pressure, HOMA-IR, lipids status. These data indicate that lower peak GH is positively associated with hyperuricemia in obese children and adolescents without known hypothalamic/pituitary disease after controlling BMI and insulin resistance, as well as other cardiometabolic risk factors.

Effect of One-Year Growth Hormone Therapy on Cardiometabolic Risk Factors in Boys with Obesity

“…During the last decades, several studies indicated that GH secretion was negatively associated with cardiovascular complications in obese adults [7][8][9][10][11]. Our previous studies also confirmed the abnormalities of the GH/insulin-like growth factor 1 (IGF-1) axis in children with obesity [12], and the reduced GH and IGF-1 secretion were independently associated with cardiovascular risk factors such as metabolic syndrome [12], hyperuricemia [13], and nonalcoholic fatty liver disease (NAFLD) [14,15].…”

Impact of BMI on peak growth hormone responses to provocative tests and therapeutic outcome in children with growth hormone deficiency

“…In our study, peak-stimulated GH was not associated with serum IGF-1 level, but IGF-1 was higher and the therapeutic response to GHT was better in other groups compared to the obese group. However, data on serum IGF-I level in obese individuals are controversial, with studies reporting low 21–24 , high 25–27 , and normal levels 28,29 . Moreover, some studies have reported no relationship between IGF-1 and BMI SDS, and increased IGF-1 in obese GHD which supports our results 30 .…”

Impact of body mass index on growth hormone stimulation tests in children and adolescents: a systematic review and meta-analysis

“…Most studies used a radioimmunoassay to measure GH in plasma or serum [26-30,32-34, 37-43,45-48,50-52,54-57,60-66,69, 71-77,79]. In more recent studies, chemiluminescence or enzyme-linked immunometric assays were used [24,25,35,36,44,49,67,70,80,81]. Five studies mentioned the use of calibrated GH assays [24,33,57,61,62].…”

“…One study found that peak GH levels in children with obesity after hexarelin, a synthetic neuropeptide with strong GH-stimulating effects, were similar to those found in children without obesity after GHRH [46]. In 14 studies, IGF-1 levels were also measured [26,27,33,44,47,50,52,54,58,[62][63][64]72,73] and were found to be in the normal range or high in children with vs. without obesity. Perotti et al found that the fat mass index on a dual-energy Xray absorptiometry scan (DXA-scan) correlated more strongly to peak GH than BMI [58].…”