ECE2023 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (159 abstracts)
Obesity-Associated Hepatic Steatosis, Somatotropic Axis Impairment and Ferritin Levels are Strong Predictors of COVID–19 Severity
Davide Masi 1 , Elena Gangitano 1 , Luca Marino 1 , Anna Criniti 1 , Laura Ballesio 2 , Antonella Anzuini 1 , Antonio Angeloni 3 , Lucio Gnessi 1 , Orietta Gandini 4 & Carla Lubrano 1
1Sapienza University, Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Italy; 2Sapienza University, Department of Radiology, Anatomo–Pathology and Oncology, Italy; 3Sapienza University, Emergency Medicine Unit, Department of Emergency-Acceptance, Critical Areas and Trauma, Italy; 4Sapienza University, Department of Molecular Medicine, Italy
Purpose: From a clinical perspective, the full spectrum of Sars–CoV–2–infected patients has not yet been defined. This study aimed to evaluate whether liver density on computed tomography (CT) scan and serum insulin-like growth factor 1 (IGF1) values can explain the clinical variability of COVID–19 cases.
Methods: We performed a retrospective study including SARS–CoV–2–infected patients hospitalized from March 2020 to May 2021 at Umberto I Polyclinic of Rome. Patients were divided into four groups (0–mild, 1–moderate, 2–severe, and 3–critical) according to respiratory failure. Routine laboratory examinations, BMI, liver steatosis indices, CT quantification of hepatic attenuation, and IGF1 serum levels have been assessed and correlated with COVID–19 severity. Hepatic attenuation was defined as the mean density of three regions of interest expressed in Hounsfield (HU).
Results: Mean liver density was 50.7±9.5 HU, whereas mean GH and IGF1 were 0.92±1.06 ng/ml and 97.2±63.4 ng/ml, respectively. Analysis of variance between groups showed that patients with worse prognoses had higher BMI, lower liver density, and significantly lower concentrations of albumin, GH, and IGF–1. ROC analysis confirmed the prognostic accuracy of serum IGF1 in discriminating patients with the occurrence of death/severe respiratory failure. (AUC 0.688, CI: 0.587 to 0.789, P< 0.001). A multivariate analysis considering the degrees of severity of the disease as the dependent variable and ferritin, liver density, and the standard deviation score of IGF1 as regressors showed that all three parameters were significant predictors (B=0.37, P<0.001; B=–0.36, P<0.001 and B= –0.21, P=0.03 respectively).
Conclusions: IGF-1 and liver steatosis account for the increased risk of poor prognosis in COVID-19 patients with obesity.
Keywords: Liver steatosis; liver density; obesity; SARS-CoV-2 infection; COVID-19; ferritin; growth hormone; IGF1
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Endocrine Abstracts
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