The Change Of Serum Pregnancy Associated Plasma Protein A Levels And Influencing Factors In Adult Growth Hormone Deficiency Patients

Objective Comparison of serum pregnancy associated plasma protein A(PAPP-A) levels in adult growth hormone deficiency(AGHD) patients and healthy adult and the relationship of serum pregnancy associated plasma protein A with glucose and lipid metabolism, blood pressure, free fatty acids, C-reactive protein and other relations.Methods The levels of fasting serum pregnancy associated plasma protein A was measured by enzyme-linked immunosorbent assay(ELISA) in 20 cases of adult growth hormone deficiency patients and 20 healthy adults. Meanwhile, it was measured in fasting plasma glucose(FPG), lipid profile, fasting insulin level, free fatty acid and C-reactive protein and so on.. BMI were evaluated and insulin sensitivity was accessed by HOMA-IR and HOMA-β.Statistical evaluation was performed with SPSS software version 17.0 to compare the serum pregnancy associated plasma protein A,anthropo- metric indexes, blood pressure, blood glucose, lipid profile, fasting insulin, free fatty acids, C-reactive protein and insulin-like growth factors-Ⅰin adult growth hormone deficiency patients and healthy adult. The significance level was set at P<0.05. Multiple linear regression model has been used ,while PAPP-A has been regarded as dependent variable, age, body mass index, waist circumference, waist-hip ratio, systolic blood pressure, 2-hour postprandial blood glucose, triglycerides, fasting insulin and HOMA-IR has been regarded as independent variables.Results The serum pregnancy associated plasma protein A level in adult growth hormone deficiency patients was significantly higher than that of control group ([7.62±1.62 vs 6.54±1.31] mIU/L, P<0.05). PAPP-A is positively correlated to age, body mass index, waist circumference, waist-hip ratio, systolic blood pressure, 2-hour postprandial blood glucose, triglycerides, fasting insulin, HOMA-IR. After adjusted the waist circumference, waist-hip ratio, 2-hour postprandial blood glucose, triglycerides, the serum pregnancy associated plasma protein A in adult growth hormone deficiency patients is positively correlated to BMI(r=0.728 P<0.05), fasting insulin(r=0.433 P<0.05). In a Multiple step-wise regression analysis, BMI, 2-hour postprandial glucose, fasting insulin, HOMA-IR are independent factors related to serum pregnancy associated plasma protein A in adult growth hormone deficiency patients.Conclusion This study shows that serum pregnancy associated plasma protein A in adult growth hormone deficiency patients are increased. Serum pregnancy associated plasma protein A is correlated with BMI, 2-hour postprandial glucose, fasting insulin, HOMA-IR. This study suggests serum pregnancy associated plasma protein A may be associated with atherosclerosis and glucose metabolism in adult growth hormone deficiency patients.