Sas T, de Muinck Keizer-Schrama S, Aanstoot H J, Stijnen T, Drop S
Department of Paediatrics, Sophia Children's Hospital, The Netherlands.
Clin Endocrinol (Oxf). 2000 Jun;52(6):741-7. doi: 10.1046/j.1365-2265.2000.01007.x.
To assess possible side-effects of treatment with supraphysiological GH dosages on carbohydrate (CH) metabolism in girls with Turner syndrome (TS) during GH treatment until adult height is reached as well as after discontinuation of GH treatment.
In a prospective, randomized injection frequency-response study, the effect of GH treatment in combination with low dose ethinyl oestradiol on CH metabolism was evaluated, comparing twice daily (BID) with once daily (OD) injections of a total GH dose of 6 U/m2/day until adult height was reached.
Nineteen untreated girls with TS, mean (SD) pretreatment age 13.3 (1.7) (range 11.0-17.6) year.
Glucose and insulin concentrations during oral glucose tolerance tests (OGTT) were measured before and during GH treatment, as well as at 6 months after discontinuation of GH treatment.
GH treatment was discontinued after a mean of 43 (range 27-57) months. In one of the 19 girls, a different girl at each time point before, during and after discontinuation of GH treatment, the glucose response to OGTT after 120 minutes was above 7.8 mmol/l but below 11.1 mmol/l, indicating impaired glucose tolerance. None of the girls developed diabetes mellitus. Fasting glucose levels did not significantly change during, or after discontinuation of GH treatment. The 3 h area under the curve for time-concentration adjusted for fasting levels during the OGTT for glucose showed a significant decrease during GH treatment. In contrast to the glucose levels, GH treatment induced considerably higher insulin levels compared to pretreatment values. After discontinuation of GH insulin levels decreased to values comparable with pretreatment levels. None of these observed changes were different between the GH injection frequency groups. The changes in CH variables during and after discontinuation of GH were not related to changes in body mass index.
GH treatment with 6 U/m2/day in combination with low dose ethinyl oestradiol in girls with Turner syndrome aged > or =11 years did not negatively influence glucose levels, but induced higher levels of insulin indicating relative insulin resistance. These changes in insulin levels were independent of the frequency of the GH injections (once vs. twice daily). After discontinuation of GH treatment, insulin values decreased to baseline levels.
评估超生理剂量生长激素（GH）治疗对特纳综合征（TS）女孩碳水化合物（CH）代谢的可能副作用，观察时间为GH治疗直至达到成人身高阶段以及停止GH治疗后。
在一项前瞻性、随机注射频率反应研究中，评估GH联合低剂量炔雌醇治疗对CH代谢的影响，比较每日两次（BID）与每日一次（OD）注射总量为6 U/m²/天的GH直至达到成人身高的情况。
19名未经治疗的TS女孩，治疗前平均（标准差）年龄为13.3（1.7）岁（范围11.0 - 17.6岁）。
在GH治疗前、治疗期间以及停止GH治疗后6个月，测量口服葡萄糖耐量试验（OGTT）期间的葡萄糖和胰岛素浓度。
平均43（范围27 - 57）个月后停止GH治疗。在19名女孩中的1名，在GH治疗前、治疗期间和停止治疗后的每个时间点为不同女孩，120分钟后OGTT的葡萄糖反应高于7.8 mmol/l但低于11.1 mmol/l，表明葡萄糖耐量受损。没有女孩患糖尿病。空腹血糖水平在GH治疗期间或停止治疗后没有显著变化。OGTT期间经空腹水平调整后的葡萄糖时间 - 浓度曲线下3小时面积在GH治疗期间显著下降。与葡萄糖水平相反，GH治疗诱导的胰岛素水平比治疗前值高得多。停止GH治疗后胰岛素水平降至与治疗前水平相当的值。这些观察到的变化在GH注射频率组之间没有差异。GH治疗期间及停止治疗后CH变量的变化与体重指数的变化无关。
≥11岁的特纳综合征女孩每日6 U/m²联合低剂量炔雌醇的GH治疗对葡萄糖水平没有负面影响，但诱导更高的胰岛素水平，表明相对胰岛素抵抗。这些胰岛素水平的变化与GH注射频率（每日一次与每日两次）无关。停止GH治疗后，胰岛素值降至基线水平。
