Iglesias P, Selgas R, Méndez J, Fernández-Reyes M J, Bajo M A, Aguilera A, Díez J J
Department of Endocrinology, Hospital General, Segovia, Spain.
Nephrol Dial Transplant. 2000 Jun;15(6):856-61. doi: 10.1093/ndt/15.6.856.
We recently have reported the first randomized, controlled study on the effects of short-term recombinant human growth hormone (rhGH|| therapy on the nutritional status of a group of malnourished adult dialysis patients. In order to evaluate whether rhGH administration exerts any influence on GH, thyrotropin (TSH|| and prolactin (PRL|| responses to TSH-releasing hormone (TRH||, we assessed these responses before and after rhGH therapy.
GH, PRL and TSH responses to TRH before and 1 month after rhGH therapy in a group of adult dialysis patients were evaluated. Seventeen dialysis patients (11 on continuous ambulatory peritoneal dialysis/six on haemodialysis|| were studied (rhGH group, n=8; control group, n=9||. In the rhGH group, 0.2 IU/kg/day rhGH was administered subcutaneously. Each patient was tested with TRH (400 microg bolus i.v.|| on two separate occasions, just before and immediately after the treatment period.
rhGH treatment did not modify baseline serum GH concentrations (6.6+/-2.7 vs 4.1+/-1.1 microg/l||, paradoxical GH responses to TRH (six out of eight patients||, GH peak (11.9+/-4.6 vs 11.2+/-5.3 microg/l, NS|| or area under the secretory curve of GH (GH AUC; 19.1+/-4.5 vs 12.1+/-3.1 microg/h/l||. Both basal PRL (35.5+/-7.1 vs 36.7+/-8.6 microg/l|| and TSH (2.3+/-1.1 vs 2.8+/-1.7 mU/l|| concentrations, as well as their responses to TRH stimulation (PRL peak, 59.9+/-16.6 vs 59. 5+/-11.8 microg/l; TSH peak, 6.2+/-2.6 vs 7.1+/-3.9 mU/l||, were also unaffected by rhGH therapy.
These results suggest that short-term rhGH therapy does not significantly influence the magnitude of the somatotropic, lactotropic or thyrotropic response to TRH in adult dialysis patients. However, this finding has to be interpreted with caution due to the two different patient groups included in this study.
我们最近报道了第一项关于短期重组人生长激素(rhGH)治疗对一组营养不良的成年透析患者营养状况影响的随机对照研究。为了评估rhGH给药是否对生长激素(GH)、促甲状腺激素(TSH)和催乳素(PRL)对促甲状腺激素释放激素(TRH)的反应产生任何影响,我们在rhGH治疗前后评估了这些反应。
评估了一组成年透析患者在rhGH治疗前和治疗1个月后对TRH的GH、PRL和TSH反应。研究了17名透析患者(11名持续非卧床腹膜透析患者/6名血液透析患者)(rhGH组,n = 8;对照组,n = 9)。rhGH组皮下注射0.2 IU/kg/天的rhGH。每位患者在治疗期之前和之后分别两次接受TRH(400μg静脉推注)测试。
rhGH治疗未改变基线血清GH浓度(6.6±2.7对4.1±1.1μg/L)、对TRH的反常GH反应(8名患者中的6名)、GH峰值(11.9±4.6对11.2±5.3μg/L,无显著性差异)或GH分泌曲线下面积(GH AUC;19.1±4.5对12.1±3.1μg/h/L)。基础PRL(35.5±7.1对36.7±8.6μg/L)和TSH(2.3±1.1对2.8±1.7 mU/L)浓度,以及它们对TRH刺激的反应(PRL峰值,59.9±16.6对59.5±11.8μg/L;TSH峰值,6.2±2.6对7.1±3.9 mU/L)也不受rhGH治疗的影响。
这些结果提示,短期rhGH治疗对成年透析患者对TRH的生长激素、催乳素或促甲状腺激素反应的幅度没有显著影响。然而,由于本研究纳入的两组患者不同,这一发现必须谨慎解读。