Gibney J, Wallace J D, Spinks T, Schnorr L, Ranicar A, Cuneo R C, Lockhart S, Burnand K G, Salomon F, Sonksen P H, Russell-Jones D
Department of Medicine, St. Thomas Hospital, London, United Kingdom.
J Clin Endocrinol Metab. 1999 Aug;84(8):2596-602. doi: 10.1210/jcem.84.8.5916.
The long term effects of GH replacement in adult GH-deficient (GHD) patients have not yet been clarified. We studied 21 GHD adults who originally took part in a randomized, double blind, placebo-controlled trial of GH treatment in 1987. After completion of that trial, 10 patients received continuous GH replacement for the subsequent 10 yr, whereas 11 did not. A group of 11 age- and sex-matched normal controls were also studied in 1987 and 1997. Lean body mass, as assessed by total body potassium measurement and computed tomography scanning of the dominant thigh, increased in the GH-treated group (P < 0.01 for both) only (P < 0.05 between groups for total body potassium). Low density lipoprotein cholesterol decreased in the GH-treated group (P < 0.05) only. Carotid intima media thickness was significantly greater (P < 0.05) in the untreated group than in the GH-treated group. Assessment of psychological well-being using the Nottingham Health Profile revealed improvement in overall score, energy levels, and emotional reaction in the GH-treated group compared with those in the untreated group (P < 0.02). In conclusion, GH treatment for 10 yr in GHD adults resulted in increased lean body and muscle mass, a less atherogenic lipid profile, reduced carotid intima media thickness, and improved psychological well-being.
生长激素替代疗法对成年生长激素缺乏(GHD)患者的长期影响尚未明确。我们研究了21名成年GHD患者,他们最初参与了1987年一项生长激素治疗的随机、双盲、安慰剂对照试验。该试验结束后,10名患者在随后的10年中接受了持续的生长激素替代治疗,而另外11名患者未接受治疗。1987年和1997年还对一组11名年龄和性别匹配的正常对照者进行了研究。通过全身钾测量和优势大腿计算机断层扫描评估的去脂体重仅在生长激素治疗组中增加(两者P均<0.01)(全身钾测量两组间P<0.05)。仅生长激素治疗组的低密度脂蛋白胆固醇降低(P<0.05)。未治疗组的颈动脉内膜中层厚度显著大于生长激素治疗组(P<0.05)。使用诺丁汉健康量表评估心理健康状况显示,与未治疗组相比,生长激素治疗组的总体评分、能量水平和情绪反应有所改善(P<0.02)。总之,成年GHD患者接受10年的生长激素治疗可增加去脂体重和肌肉量,改善脂质谱以降低动脉粥样硬化风险,减少颈动脉内膜中层厚度,并改善心理健康状况。