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J Clin Endocrinol Metab. 2009 Aug;94(8):2864-71. doi: 10.1210/jc.2009-0380. Epub 2009 May 12.

Relative growth hormone deficiency and cortisol excess are associated with increased cardiovascular risk markers in obese adolescent girls.

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  • 1Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA.

Abstract

CONTEXT:

Obesity in adolescents is increasingly prevalent and its impact on cardiovascular risk important to determine. Hormonal predictors of cardiovascular risk markers in obese adolescents are not known.

OBJECTIVE:

Our objective was to examine whether relative GH deficiency and cortisol excess are determinants of increased cardiovascular risk markers in obese teenage girls.

DESIGN AND SETTING:

A cross-sectional study was conducted at a clinical research center.

STUDY PARTICIPANTS:

Thirty girls (15 obese girls and 15 normal-weight controls) 12-18 years old matched for maturity and race.

MAIN OUTCOME MEASURES:

Inflammatory markers of cardiovascular risk including high-sensitivity C-reactive protein (hsCRP), TNF-alpha receptors 1 and 2, E-selectin, soluble intercellular adhesion molecule-1, and IL-6 were analyzed. Leptin, adiponectin, and 24-h urine free cortisol (UFC) were also measured. A GHRH-arginine stimulation test was performed.

RESULTS:

The hsCRP levels were higher in obese girls than controls (4.63 +/- 4.81 vs. 0.67 +/- 0.72 mg/liter; P = 0.002 after log conversion), as were other markers of cardiovascular risk. Eight of the 15 obese girls but no normal-weight girl had hsCRP higher than 3 mg/liter (P = 0.002). Body mass index sd score was higher than 4.0 in 87.5% of girls with hsCRP higher than 3 mg/liter and no girls with hsCRP less than 3 mg/liter. Girls with hsCRP higher than 3 mg/liter had higher UFC and lower peak GH compared with those with hsCRP less than 3 mg/liter. Peak GH was an important negative predictor of most markers of increased cardiovascular risk. In addition to peak GH, UFC and adiponectin independently predicted hsCRP.

CONCLUSION:

Relative GH deficiency and cortisol excess are significant contributors to increased levels of markers of cardiovascular risk in obese adolescent girls.

PMID:
19435823
[PubMed - indexed for MEDLINE]
PMCID:
PMC2730871
Free PMC Article

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