medwireNews: Obese children with reduced peak stimulated growth hormone (GH) are likely to have hyperuricaemia, along with markers of increased cardiovascular risk, research shows.

Peak GH in response to the arginine-levodopa stimulation test was markedly lower in the 78 obese children and adolescents in the study (average BMI standard deviation score [SDS] 2.51) than in 30 control children of healthy weight, at 4.08 versus 16.31 µg/L. They also had significantly lower levels of insulin-like growth factor-1, at 268.36 versus 390.25 ng/mL, and this was despite no difference in height SDS.

And among the obese children, peak GH was lower still in the 45 with hyperuricaemia (serum uric acid >5.5 mg/dL) than in those without, at 2.91 versus 5.68 µg/L, a significant difference.

In fact, Jiang Xue (The Second Hospital of Shandong University, China) and co-researchers found a significant negative correlation between peak GH and uric acid. They suggest that the association could be mediated by leptin levels, insulin resistance, or oxidative and inflammatory changes.

Children with hyperuricaemia also had significantly higher levels of insulin, triglycerides and alanine aminotransferase, and lower levels of high-density lipoprotein (HDL) cholesterol, than those without, and they were more insulin resistant. Again, higher uric acid levels were associated with higher levels of these cardiovascular risk markers (lower levels for HDL cholesterol).

The team also found that higher peak stimulated GH was significantly associated with an increased risk of having the metabolic syndrome, after accounting for age, sex and Tanner stage.

“Reduced peak stimulated growth hormone may play an independent role in hyperuricemia, increasing cardiovascular disease risk markers and metabolic syndrome in obesity”, Xue and team write in Scientific Reports.

“Thus, our findings suggested that additional investigation for GH status might be warranted in obese subjects and [should be] considered in the clinical evaluation of their metabolic risk profile.”

They speculate that GH replacement in obese children might improve their hyperuricaemia, thus reducing their cardiovascular risk, but stress that further research is necessary.

Eleanor McDermid

Sci Rep 2018; Advance online publication

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