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Title of Journal: J Endocrinol Invest

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Abbravation: Journal of Endocrinological Investigation

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Springer International Publishing

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DOI

10.1007/s10563-011-9123-y

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1720-8386

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Growth hormone status in morbidly obese subjects a

Authors: S Savastano C Di Somma A Belfiore B Guida F Orio F Rota M C Savanelli T Cascella A Mentone L Angrisani G Lombardi A Colao
Publish Date: 2014/03/11
Volume: 29, Issue: 6, Pages: 536-543
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Abstract

Morbidly obese subjects are characterized by multiple endocrine abnormalities and these are paralleled by unfavorable changes in body composition In obese individuals either 24h spontaneous or stimulated GH secretion is impaired without an organic pituitary disease and the severity of the secretory defect is proportional to the degree of obesity The GHRH+arginine GHRH+ARG test is likely to be the overall test of choice in clinical practice to differentiate GH deficiency GHD patients Similarly to other provocative tests GHRH+ARG is influenced by obesity per se Therefore a new cutoff limit of peak GH response of 42 µg/l in obese subjects has been recently assumed The aim of the present study was to investigate the reciprocal influence between decreased GH secretion and body composition in a group of 110 morbidly obese subjects using the new cutoff limit of peak GH response to GHRH+ARG test for these subjects In our study GHD was identified in 273 of the obese subjects without gender difference In GDH obese subjects body mass index BMI waist circumference waisttohip ratio WHR fat mass FM and resistance R were higher while reactance Xc phase angle body cell mass BCM IGFI or IGFI zscores were lower than in normal responders p0001 In all obese subjects GH peak levels showed a negative correlation with age BMI waist circumference and FM and a positive correlation with IGFI In the stepwise multiple linear regression waist circumference and FM were the major determinants of GH peak levels and IGFI In conclusion using the new cutoff limit of peak GH response to GHRH+ARG test for obese subjects about 1/3 morbidly obese subjects were GHD GHD subjects showed a significantly different body composition compared with normal responders and the secretory defect was correlated to different anthropometric variables with waist circumference and FM as the major determinants

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