Dinser R, Halama T, Hoffmann A
Klinik II und Poliklinik für Innere Medizin, University of Cologne, Germany.
J Rheumatol. 2000 Oct;27(10):2482-8.
Several reports suggest that growth hormone (GH) deficiency may be a pathogenic factor in fibromyalgia syndrome (FM). This hypothesis has never been adequately examined.
We measured serum GH concentration after insulin induced hypoglycemia in subjects with FM. GH secretion in subjects with a maximal GH increase < 10 ng/ml after hypoglycemia was assessed by additional arginine stimulation.
In one of 56 subjects tested, GH remained below 3 ng/ml in both tests, satisfying the criteria for adult GH deficiency. Thirty-two subjects (67%) had a maximal GH > 10 ng/ml. We retrospectively found an inverse correlation between low density lipoprotein levels and maximal GH concentration in a subgroup of patients.
Severe GH deficiency is not a significant pathogenic factor in most patients with FM. We observed an impaired reactivity of the somatotropic axis in one-third of patients with FM, in keeping with a functional alteration of the hypothalamus.
多项报告表明,生长激素(GH)缺乏可能是纤维肌痛综合征(FM)的致病因素。这一假说从未得到充分验证。
我们测定了FM患者在胰岛素诱发低血糖后的血清GH浓度。对于低血糖后最大GH增加值<10 ng/ml的患者,通过额外的精氨酸刺激来评估GH分泌情况。
在56名接受测试的受试者中,有1名在两次测试中GH均低于3 ng/ml,符合成人GH缺乏的标准。32名受试者(67%)的最大GH>10 ng/ml。我们回顾性地发现,在一组患者中,低密度脂蛋白水平与最大GH浓度呈负相关。
严重GH缺乏在大多数FM患者中并非重要的致病因素。我们观察到三分之一的FM患者生长激素轴反应受损,这与下丘脑的功能改变一致。