{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T21:12:29Z","timestamp":1790975549907,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,8,14]],"date-time":"2012-08-14T00:00:00Z","timestamp":1344902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Both growth hormone (<jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content>) excess and <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> deficiency are associated with abnormalities in body composition and biomarkers of cardiovascular risk in patients with pituitary disorders. However, the effects of developing <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> deficiency after definitive treatment of acromegaly are largely unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether development of <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> deficiency after definitive therapy for acromegaly is associated with increased visceral adiposity and biomarkers of cardiovascular risk compared with <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> sufficiency after definitive therapy for acromegaly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Cross\u2010sectional.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>We studied three groups of subjects, all with a history of acromegaly (<jats:italic>n<\/jats:italic>\u00a0=\u00a076): subjects with subsequent <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> deficiency (<jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content>;<jats:italic> n<\/jats:italic>\u00a0=\u00a031), subjects with subsequent <jats:styled-content style=\"fixed-case\">GH<\/jats:styled-content> sufficiency (<jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content>;<jats:italic> n<\/jats:italic>\u00a0=\u00a025) and subjects with active acromegaly (<jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content>;<jats:italic> n<\/jats:italic>\u00a0=\u00a020). No study subjects were receiving somatostatin analogues, dopamine agonists or <jats:styled-content style=\"fixed-case\">hGH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Body composition (by <jats:styled-content style=\"fixed-case\">DXA<\/jats:styled-content>), abdominal adipose tissue depots (by cross\u2010sectional <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>), total body water (by bioimpedance analysis) and carotid intima\u2010media thickness (<jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content>) were measured. Fasting morning serum was collected for high\u2010sensitivity <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>\u2010reactive protein (hs<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>), lipids and lipoprotein levels. An oral glucose tolerance test was performed, and homoeostasis model of assessment\u2010insulin resistance (<jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content>) was calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Abdominal visceral adipose tissue, total adipose tissue and total body fat were higher in subjects with <jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). Subcutaneous abdominal fat was higher, and fibrinogen and <jats:styled-content style=\"fixed-case\">IMT<\/jats:styled-content> were lower in <jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content> (but not <jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content>) than <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). Patients with <jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content> had the highest hs<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content>, followed by <jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content>, and hs<jats:styled-content style=\"fixed-case\">CRP<\/jats:styled-content> was lowest in <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). Fasting glucose, 120\u2010min glucose, fasting insulin, <jats:styled-content style=\"fixed-case\">HOMA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IR<\/jats:styled-content> and per cent total body water were lower in <jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). Triglycerides were higher in <jats:styled-content style=\"fixed-case\">GHS<\/jats:styled-content> than <jats:styled-content style=\"fixed-case\">AA<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0\u00b705). Lean body mass, mean arterial pressure, total cholesterol, <jats:styled-content style=\"fixed-case\">HDL<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LDL<\/jats:styled-content> were comparable among groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Development of <jats:styled-content style=\"fixed-case\">GHD<\/jats:styled-content> after definitive treatment of acromegaly may adversely affect body composition and inflammatory biomarkers of cardiovascular risk but does not appear to adversely affect glucose homoeostasis, lipids and lipoproteins, or other cardiovascular risk markers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2265.2012.04361.x","type":"journal-article","created":{"date-parts":[[2012,2,9]],"date-time":"2012-02-09T01:55:31Z","timestamp":1328752531000},"page":"430-438","source":"Crossref","is-referenced-by-count":33,"title":["Effects of growth hormone deficiency on body composition and biomarkers of cardiovascular risk after definitive therapy for acromegaly"],"prefix":"10.1111","volume":"77","author":[{"given":"E.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Neuroendocrine Unit Massachusetts General Hospital and Harvard Medical School  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. 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