Grøfte T, Jensen D S, Greisen J, Tygstrup N, Vilstrup H
Department of Hepatology V, Aarhus University Hospital, DK-8000 C, Aarhus, Denmark
J Hepatol. 2001 Dec;35(6):700-6. doi: 10.1016/s0168-8278(01)00255-0.
BACKGROUND/AIMS: Long-term steroid treatment causes protein wasting. Liver contributes towards this by upregulating ureagenesis. Growth hormone (GH) and insulin-like growth factor-I (IGF-I) are anabolic agents with specific hepatic effects. It is unknown whether IGF-I alone and/or in combination with GH have any effect on established hepatic amino-N catabolism during long-term glucocorticoid treatment.
We measured the spontaneous (UNSR) and the substrate standardized rate of urea nitrogen synthesis (STUNSR), N-balance and mRNA levels of urea cycle enzymes in controls (placebo) and four longterm steroid treated groups given (1) prednisolone 4 mg/kg/day during 28 days (St) (2) +GH 1 mg/kg/day from day 21-28 (StGH) (3) +IGF-I 1.5 mg/kg/day 21-28 (StIGF) (4) GH +IGF-I (StGHIGF).
Steroid induced weight loss was stepwisely reversed by IGF-I, GH and both. UNSR, STUNSR and mRNA levels of urea cycle enzymes in the liver increased markedly after steroid treatment, and was normalized after co-administration of GH and IGF-I. N-balance improved after GH and IGF-I administration.
Our results expands the knowledge of beneficial effects of GH on short-term steroid catabolism to include effects of IGF-I and IGF-I combined with GH on long-term steroid catabolism. Both peptides prevent steroid induced hepatic protein wasting and thereby contribute towards whole body anabolism. The effect in vivo is probably due to an effect of the peptides on urea cycle enzyme mRNA.
背景/目的:长期使用类固醇治疗会导致蛋白质消耗。肝脏通过上调尿素生成对此起到促进作用。生长激素(GH)和胰岛素样生长因子-I(IGF-I)是具有特定肝脏作用的合成代谢剂。目前尚不清楚单独使用IGF-I和/或与GH联合使用是否会对长期糖皮质激素治疗期间已建立的肝脏氨基氮分解代谢产生影响。
我们测量了对照组(安慰剂)以及四个长期接受类固醇治疗的组的尿素氮合成的自发率(UNSR)和底物标准化率(STUNSR)、氮平衡以及尿素循环酶的mRNA水平,这四个组分别为:(1)在28天内给予泼尼松龙4mg/kg/天(St);(2)从第21天至28天给予+GH 1mg/kg/天(StGH);(3)从第21天至28天给予+IGF-I 1.5mg/kg/天(StIGF);(4)给予GH + IGF-I(StGHIGF)。
类固醇引起的体重减轻通过IGF-I、GH以及两者联合使用逐步得到逆转。类固醇治疗后,肝脏中尿素循环酶的UNSR、STUNSR和mRNA水平显著升高,在联合使用GH和IGF-I后恢复正常。给予GH和IGF-I后氮平衡得到改善。
我们的结果将GH对短期类固醇分解代谢的有益作用的认识扩展到包括IGF-I以及IGF-I与GH联合使用对长期类固醇分解代谢的影响。这两种肽均可防止类固醇诱导的肝脏蛋白质消耗,从而有助于全身合成代谢。体内的这种作用可能是由于这些肽对尿素循环酶mRNA的影响。