Agardh C D, Agardh E, Eckert B, Sjöberg U
Department of Internal Medicine, University Hospital, Lund, Sweden.
Diabetes Res. 1992 Feb;19(2):81-5.
Sixteen young patients with type 1 diabetes mellitus and rapidly progressive severe retinopathy were examined regarding serum levels of growth hormone before and after the i.v. administration of 200 micrograms thyrotropin-releasing hormone (TRH). Serum IGF I, HbA1c, blood pressure, urinary albumin, and serum creatinine levels were also measured. The control group consisted of type 1 diabetic patients matched for age, duration of diabetes and metabolic control with no or minimal background retinopathy. The results show that basal growth hormone levels were above normal in both groups, and that there was a paradoxical increment in growth hormone levels after TRH stimulation (p < 0.05) in patients with severe retinopathy, but the values did not differ from patients with background retinopathy. IGD I levels were normal in all patients but one, and no differences were seen between the two groups. HbA1c, serum creatine, blood pressure, and urinary albumin levels were similar in the groups but patients with severe retinopathy were treated with more insulin (p < 0.001). Thus, neither abnormal growth hormone levels, nor IGF I, seems to be associated with the development of severe retinopathy in young type 1 diabetic patients.
对16例1型糖尿病伴快速进展性严重视网膜病变的年轻患者,在静脉注射200微克促甲状腺激素释放激素(TRH)前后检测其血清生长激素水平。同时测定血清胰岛素样生长因子I(IGF I)、糖化血红蛋白(HbA1c)、血压、尿白蛋白及血清肌酐水平。对照组为年龄、糖尿病病程及代谢控制情况相匹配的1型糖尿病患者,无或仅有轻微的背景性视网膜病变。结果显示,两组患者的基础生长激素水平均高于正常,严重视网膜病变患者在TRH刺激后生长激素水平出现反常升高(p<0.05),但与背景性视网膜病变患者的值无差异。除1例患者外,所有患者的IGF I水平均正常,两组之间未见差异。两组患者的HbA1c、血清肌酐、血压及尿白蛋白水平相似,但严重视网膜病变患者使用的胰岛素更多(p<0.001)。因此,异常的生长激素水平和IGF I似乎均与年轻1型糖尿病患者严重视网膜病变的发生无关。