Møller S, Fisker S, Becker U, Henriksen J H
Department of Clinical Physiology, Hvidovre Hospital, Hvidovre, Denmark.
Metabolism. 2001 Nov;50(11):1340-5. doi: 10.1053/meta.2001.27207.
The growth hormone (GH)/insulin-like growth factor-I (IGF-I) axis is disturbed in cirrhosis, with elevated basal GH and low IGF-I levels relating to liver function and prognosis. In plasma, GH is bound to a high-affinity GH-binding protein (GHBP), which has been found to be slightly reduced in cirrhosis, but with huge variations. GHBP is identical to the extracellular part of the hepatic GH receptor, but other tissues may contribute to the circulating GHBP levels. The aim was therefore to measure circulating and regional concentrations of GHBP in relationship to hepatic function and body composition in patients with cirrhosis (n = 38) and controls with normal liver function (n = 29). Blood samples from the hepatic, renal, and femoral veins and the femoral artery were collected simultaneously during a hemodynamic investigation. Plasma GHBP was directly measured by a specific and sensitive fluoroimmunoassay. Circulating GHBP levels were identical in the patients and controls (mean +/- SD) 1.03 +/- 0.56 nmol/L and 1.02 +/- 0.55 nmol/L, respectively (not significant). We found no significant hepatic, renal, or peripheral arteriovenous extractions or generations of GHBP, and it did not significantly correlate to liver function. In the controls, GHBP correlated significantly with body mass index (BMI) (r =.60, P <.005), whereas this relationship was not found in the patients with cirrhosis. In conclusion, high-affinity GHBP appears to be normal in patients with cirrhosis, with no significant hepatic generation or renal extraction and no association with the severity of the liver disease. Thus, our study supports the hypothesis that tissues other than the liver, despite its abundant GH receptors, may contribute to the circulating GHBP.
生长激素（GH）/胰岛素样生长因子-I（IGF-I）轴在肝硬化中受到干扰，基础GH升高和IGF-I水平降低与肝功能及预后相关。在血浆中，GH与高亲和力的生长激素结合蛋白（GHBP）结合，已发现肝硬化患者的GHBP略有降低，但差异很大。GHBP与肝脏GH受体的细胞外部分相同，但其他组织可能对循环中的GHBP水平有贡献。因此，本研究旨在测量肝硬化患者（n = 38）和肝功能正常的对照组（n = 29）中循环和局部GHBP浓度与肝功能和身体组成的关系。在血流动力学研究期间，同时采集肝静脉、肾静脉、股静脉和股动脉的血样。采用特异性和灵敏的荧光免疫分析法直接测定血浆GHBP。患者和对照组的循环GHBP水平相同（均值±标准差），分别为1.03±0.56 nmol/L和1.02±0.55 nmol/L（无显著性差异）。我们未发现GHBP有显著的肝脏、肾脏或外周动静脉摄取或生成，且其与肝功能无显著相关性。在对照组中，GHBP与体重指数（BMI）显著相关（r = 0.60，P < 0.005），而在肝硬化患者中未发现这种关系。总之，肝硬化患者的高亲和力GHBP似乎正常，无显著的肝脏生成或肾脏摄取，且与肝脏疾病的严重程度无关。因此，我们的研究支持以下假说：除肝脏外，尽管肝脏有丰富的GH受体，但其他组织可能对循环中的GHBP有贡献。
