Kohno H, Ueyama N, Honda S
Department of Endocrinology and Metabolism, Fukuoka Children's Hospital, Japan.
Diabetes Obes Metab. 1999 Sep;1(5):293-6. doi: 10.1046/j.1463-1326.1999.00048.x.
Growth hormone (GH) plays an important role in the regulation of body composition and metabolism. GH deficiency is associated with obesity and hypercholesterolemia, which respond to GH treatment. In this study we evaluated changes in body composition and cholesterol profiles after discontinuation of GH therapy to assess atherogenic risk factors in GH-deficient patients.
We studied 18 male patients with GH deficiency 17-20 years of age at the time of discontinuing GH therapy. Body composition and cholesterol were measured 6 months before discontinuation of GH therapy with a weekly dose of 0.5 IU/kg (approximately 0.19 mg/kg), and immediately, 2 months, and 6 months after the end of GH therapy.
Two months after termination of GH therapy the percentage of body fat and fat mass increased from 7.4% to 9.4% and from 3.8 kg to 5.0 kg, respectively, and remained high thereafter. Lean body mass decreased gradually, but the change was not significant. Lean body mass: fat mass ratio decreased from 14.7 at termination of GH therapy to 10.9 at the end of study. Total cholesterol (TC) showed a significant linear increase from 156 mg/dl immediately after discontinuation to 169 mg/dl 6 months after discontinuation of GH, whereas high-density lipoprotein cholesterol (HDLC) showed no change during the study. The TC to HDLC ratio showed a slight but insignificant trend toward an increase. There were no significant changes in any variables during the last 6 months of GH therapy.
GH therapy in patients with GH deficiency can reduce risk factors for obesity-related diseases and atherosclerosis. These beneficial effects are reversed after discontinuation of GH therapy. Further long-term studies of the effects of the GH withdrawal on lipid profiles, adiposity and life expectancy must be performed.
生长激素（GH）在身体成分和代谢调节中起重要作用。生长激素缺乏与肥胖和高胆固醇血症相关，而这些情况对生长激素治疗有反应。在本研究中，我们评估了生长激素治疗中断后身体成分和胆固醇谱的变化，以评估生长激素缺乏患者的动脉粥样硬化危险因素。
我们研究了18名在停止生长激素治疗时年龄为17 - 20岁的男性生长激素缺乏患者。在停止每周剂量为0.5 IU/kg（约0.19 mg/kg）的生长激素治疗前6个月、治疗结束后即刻、2个月和6个月时测量身体成分和胆固醇。
生长激素治疗终止后2个月，体脂百分比和脂肪量分别从7.4%增加到9.4%，从3.8 kg增加到5.0 kg，此后一直保持在较高水平。去脂体重逐渐下降，但变化不显著。去脂体重与脂肪量的比值从生长激素治疗终止时的14.7降至研究结束时的10.9。总胆固醇（TC）在停止生长激素治疗后即刻从156 mg/dl显著线性增加至停止治疗6个月后的169 mg/dl，而高密度脂蛋白胆固醇（HDLC）在研究期间无变化。TC与HDLC的比值有轻微但不显著的升高趋势。在生长激素治疗的最后6个月期间，任何变量均无显著变化。
生长激素缺乏患者的生长激素治疗可降低肥胖相关疾病和动脉粥样硬化的危险因素。停止生长激素治疗后，这些有益作用会逆转。必须对生长激素撤药对血脂谱、肥胖和预期寿命的影响进行进一步的长期研究。
