Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients
A. Ciresi, M. Amato, V. Guarnotta, A. Galluzzo & C. Giordano
Background: The Visceral Adiposity Index (VAI) has been suggested as a new gender-specific marker of visceral adipose dysfunction, strongly associated with insulin sensitivity in patients with cardio-metabolic risk.
Aim: To test VAI in active acromegaly for the assessment of disease-associated metabolic risk evaluating its association with hormonal data, adipocytokine levels, insulin sensitivity and secretion parameters in a cohort of 27 subjects (15 M, 12 F, mean age 54.9 years).
Methods: Glucose, HbA1c, nadir and AUC of GH during OGTT, AUC of C-peptide (CP) during a mixed-meal tolerance test (MMTT), M value during an euglycemic hyperinsulinemic clamp, leptin, adiponectin, TNF-α, IL-6 were evaluated in newly diagnosed patients grouped into those with normal (Group A, No 15; 55.5%) and high VAI (Group B, No 12; 44.5%).
Results: VAI value was positively correlated with age of patients (P=0.048), basal, nadir and AUC of GH (P=0.001, 0.007 and 0.002, respectively), IGF1 (P=0.001), TNF-α (P=0.010) and negatively with adiponectin (P<0.001). Group B showed 1) significantly higher levels of basal GH (P=0.018), AUCGH (P=0.047), IGF1 (P=0.047) and AUCCP (P=0.018); 2) significantly lower M value (P<0.001) and adiponectin levels (P<0.001); 3) higher prevalence of systolic blood pressure (P=0.006) and impaired glucose tolerance (P=0.001).
Conclusions: In active acromegaly, VAI appears to be independently associated with hormonal parameters, insulin sensitivity and secretion indexes, adiponectin and TNF-α levels. Therefore, VAI could be used as a new easy tool in daily clinical practice for the assessment of metabolic risk associated with active acromegaly.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.