This study will examine adipose tissue inflammation and adipokine expression and serum markers of inflammation and adipokine levels in patients with growth hormone (GH) deficiency before and after treatment.
The GH axis has important influences on adipose tissue. Preliminary data from the investigators' study in acromegaly, a state of GH excess, suggests that GH reduces adipose tissue (AT) mass and serum inflammation. However, GH seems to reduce macrophage markers in adipose tissue yet increase adipocyte inflammation. This novel dissociation of macrophage and adipocyte inflammation is hypothesized to be due to GH. In order to examine this hypothesis further this study will examine adipose tissue and serum inflammation in patients with GH deficiency before and after GH therapy. The investigators will obtain subcutaneous adipose tissue by biopsy in patients with active GH deficiency planning to undergo therapy for GH deficiency. Concurrently serum samples will be taken for analysis of levels of inflammatory markers and adipokines. After treatment for 12 months with a normal levels of Insulin-like growth factor 1 (IGF-1), a marker of GH deficiency, patients will have a repeat adipose tissue biopsy. Adipose tissue parameters will be analyzed in each specimen and then compared to each patient over time as well as to body mass index (BMI)-matched control subjects.
Study Type
OBSERVATIONAL
Enrollment
19
Patients will receive growth hormone replacement therapy as per standard clinical care during this study.
Neuroendocrine Unit and Pituitary Center, Columbia University Irving Medical Center
New York, New York, United States
Visceral Adipose Tissue (VAT) mass
Visceral adipose tissue mass as measured by tota body magnetic resonance imaging
Time frame: Baseline to 12 months of GH therapy
Intra-hepatic lipid level
Intra-hepatic lipid level measured by magnetic resonance imaging of liver
Time frame: Baseline to 12 months of GH therapy
Skeletal Muscle Mass
Skeletal muscle mass measured by total body magnetic resonance imaging
Time frame: Baseline to 12 months of GH therapy
Total body fat
Total body fat as measured by dual x-ray absorptiometry
Time frame: Baseline to 12 months of GH therapy
Resting metabolic rate
Resting metabolic rate
Time frame: Baseline to 12 months of GH therapy
Relative gene expression of CD68 gene
Relative gene expression values of Cluster of Differentiation 68 (CD68) gene expression in adipose tissue
Time frame: Baseline to 12 months of GH therapy
Relative gene expression values of MCP1 gene
Relative gene expression values of monocyte chemoattractant protein-1 (MCP-1) gene in adipose tissue
Time frame: Baseline to 12 months of GH therapy
Relative gene expression IL6 gene
Relative gene expression Interleukin 6 (IL6) gene in adipose tissue
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Time frame: Baseline to after 12 months of treatment for GH deficiency
Relative gene expression values of CD11c gene
Relative gene expression values of CD11c gene in adipose tissue
Time frame: Baseline to 12 months of GH therapy
interleukin 6 (IL-6) level
Plasma level of interleukin 6 (IL-6)
Time frame: Baseline to 12 months of GH therapy
TNFα level
Plasma level of tumor necrosis factor alpha (TNFα)
Time frame: Baseline to 12 months of GH therapy
CRP level
Plasma level of C-reactive protein (CRP)
Time frame: Baseline to 12 months of GH therapy
homocysteine level
Plasma level of homocysteine
Time frame: Baseline to 12 months of GH therapy