Wolthers T, Hoffman D M, Nugent A G, Duncan M W, Umpleby M, Ho K K
The Garvan Institute of Medical Research, St. Vincent's Hospital and Biomedical Mass Spectrometry Unit, University of New South Wales, Sydney, New South Wales 2010, Australia.
Am J Physiol Endocrinol Metab. 2001 Dec;281(6):E1191-6. doi: 10.1152/ajpendo.2001.281.6.E1191.
We have determined whether oral estrogen reduces the biological effects of growth hormone (GH) in GH-deficient (GHD) women compared with transdermal estrogen treatment. In two separate studies, eight GHD women randomly received either oral or transdermal estrogen for 8 wk before crossing over to the alternate route of administration. The first study assessed the effects of incremental doses of GH (0.5, 1.0, 2.0 IU/day for 1 wk each) on insulin-like growth factor I (IGF-I) levels during each estrogen treatment phase. The second study assessed the effects of GH (2 IU/day) on lipid oxidation and on protein metabolism using the whole body leucine turnover technique. Mean IGF-I level was significantly lower during oral estrogen treatment (P < 0.05) and rose dose dependently during GH administration by a lesser magnitude (P < 0.05) compared with transdermal treatment. Postprandial lipid oxidation was significantly lower with oral estrogen treatment, both before (P < 0.05) and during (P < 0.05) GH administration, compared with transdermal treatment. Protein synthesis was lower during oral estrogen both before and during GH administration (P < 0.05). Oral estrogen antagonizes several of the metabolic actions of GH. It may aggravate body composition abnormalities already present in GHD women and attenuate the beneficial effects of GH therapy. Estrogen replacement in GHD women should be administered by a nonoral route.
我们已经确定，与经皮雌激素治疗相比，口服雌激素是否会降低生长激素缺乏（GHD）女性体内生长激素（GH）的生物学效应。在两项独立研究中，8名GHD女性在交叉采用另一种给药途径之前，随机接受口服或经皮雌激素治疗8周。第一项研究评估了在每个雌激素治疗阶段，递增剂量的GH（0.5、1.0、2.0 IU/天，各持续1周）对胰岛素样生长因子I（IGF-I）水平的影响。第二项研究使用全身亮氨酸周转率技术，评估了GH（2 IU/天）对脂质氧化和蛋白质代谢的影响。与经皮治疗相比，口服雌激素治疗期间的平均IGF-I水平显著较低（P < 0.05），且在GH给药期间虽呈剂量依赖性升高，但升高幅度较小（P < 0.05）。与经皮治疗相比，口服雌激素治疗在GH给药前（P < 0.05）和给药期间（P < 0.05）的餐后脂质氧化均显著较低。在GH给药前和给药期间，口服雌激素治疗期间的蛋白质合成均较低（P < 0.05）。口服雌激素拮抗GH的多种代谢作用。它可能会加重GHD女性已有的身体成分异常，并减弱GH治疗的有益效果。GHD女性的雌激素替代治疗应采用非口服途径给药。
