Møller J, Fisker S, Rosenfalck A M, Frandsen E, Jørgensen J O, Hilsted J, Christiansen J S
Department of Endocrinology, Aarhus University Hospital, Denmark.
Eur J Endocrinol. 1999 Jan;140(1):11-6. doi: 10.1530/eje.0.1400011.
Short-term growth hormone (GH) treatment normalises body fluid distribution in adult GH deficient patients, but the impact of long-term treatment on body fluid homeostasis has hitherto not been thoroughly examined in placebo controlled trials. To investigate if the water retaining effect of GH persists for a longer time we examined the impact of 4 months GH treatment on extracellular volume (ECV) and plasma volume (PV) in GH deficient adults.
Twenty-four (18 male, 6 female) adult GH deficient patients aged 25-64 years were included and received either GH (n=11) or placebo (n=13) in a double blind parallel design.
Before and at the end of each 4 month period ECV and PV were assessed directly using 82Br- and 125I-albumin respectively, and blood samples were obtained.
During GH treatment ECV increased significantly (before: 20.48+/-0.99 l, 4 months: 23.77+/-1.38 l (P<0.01)), but remained unchanged during placebo administration (before: 16.92+/-1.01 l, 4 months: 17.60+/-1.24 l (P=0.37)). The difference between the groups was significant (P<0.05). GH treatment also increased PV (before: 3.39+/-0.27 l. 4 months: 3.71+/-0.261 (P=0.01)), although an insignificant increase in the placebo treated patients (before: 2.81+/-0.18 l, 4 months: 2.89+/-0.20 l (P=0.37)) resulted in an insignificant treatment effect (P=0.07). Serum insulin-like growth factor-I increased significantly during GH treatment and was not affected by placebo treatment. Plasma renin (mIU/l) increased during GH administration (before: 14.73+/-2.16, 4 months: 26.00+/-6.22 (P=0.03)) and remained unchanged following placebo (before: 20.77+/-5.13, 4 months: 20.69+/-6.67 (P=0.99)) leaving no significant treatment effect (P=0.08).
The long-term impact of GH treatment on body fluid distribution in adult GH deficient patients involves expansion of ECV and probably also PV. These data substantiate the role of GH as a regulator of fluid homeostasis in adult GH deficiency.
短期生长激素（GH）治疗可使成年生长激素缺乏患者的体液分布恢复正常，但长期治疗对体液稳态的影响在安慰剂对照试验中尚未得到充分研究。为了研究GH的保水作用是否会持续更长时间，我们检测了4个月GH治疗对成年生长激素缺乏患者细胞外液量（ECV）和血浆量（PV）的影响。
纳入24例（18例男性，6例女性）年龄在25 - 64岁的成年生长激素缺乏患者，采用双盲平行设计，分别给予GH（n = 11）或安慰剂（n = 13）。
在每4个月治疗期开始和结束时，分别使用82Br - 和125I - 白蛋白直接评估ECV和PV，并采集血样。
在GH治疗期间，ECV显著增加（治疗前：20.48±0.99升，4个月后：23.77±1.38升（P < 0.01）），而在安慰剂给药期间保持不变（治疗前：16.92±1.01升，4个月后：17.60±1.24升（P = 0.37））。两组间差异显著（P < 0.05）。GH治疗也使PV增加（治疗前：3.39±0.27升，4个月后：3.71±0.26升（P = 0.01）），尽管安慰剂治疗患者有轻微增加（治疗前：2.81±0.18升，4个月后：2.89±0.20升（P = 0.37）），导致治疗效果不显著（P = 0.07）。血清胰岛素样生长因子 - I在GH治疗期间显著增加，且不受安慰剂治疗影响。血浆肾素（mIU/l）在GH给药期间增加（治疗前：14.73±2.16，4个月后：26.00±6.22（P = 0.03）），在安慰剂治疗后保持不变（治疗前：20.77±5.13，4个月后：20.69±6.67（P = 0.99）），治疗效果不显著（P = 0.08）。
GH治疗对成年生长激素缺乏患者体液分布的长期影响包括ECV扩张，可能还有PV扩张。这些数据证实了GH在成年生长激素缺乏中作为体液稳态调节因子的作用。
