Klinger B, Ionesco A, Anin S, Laron Z
Institute of Pediatric and Adolescent Endocrinology, Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Acta Endocrinol (Copenh). 1992 Dec;127(6):515-9. doi: 10.1530/acta.0.1270515.
We have evaluated the effect of exogenous administration of IGF-I on the thyroid axis in four separate studies: (1) iv bolus injection; (2) single sc injection; (3) seven days' sc treatment, and (4) four months' treatment. Thirteen patients with Laron-type dwarfism (LTD) participated in the investigations. In studies 1 and 2, 10 healthy subjects were also included. Before and during long-term treatment (study 4) six LTD patients underwent a TRH test. IGF-I was administered in a dose of 75 micrograms.kg-1 iv or 120-150 micrograms.kg-1 sc. Single injections of IGF-I caused significant decreases of serum TSH in LTD patients (iv: 1.7 +/- 0.2 to 1.1 +/- 0.1 mU/l; sc: from 2.1 +/- 0.4 to 1.1 +/- 0.2; p < 0.0005). In controls the decrease was for iv from 1.2 +/- 0.2 to 0.8 +/- 0.2 mU/l (p < 0.02) and for sc from 2.0 +/- 0.5 to 0.8 +/- 0.2 mU/l (p < 0.05). Long-term administration of IGF-I induces a transitory decrease of both serum TSH and fT4, followed by a spontaneous rise to pretreatment or even higher values. No changes in T3 were observed. TSH stimulation by TRH was significantly augmented after four months of IGF-I treatment (p < 0.005). The effects of IGF-I can be explained by an early stimulation of somatostatin release causing a decrease in TSH and followed by the development of compensatory mechanisms. All changes were within the normal ranges, not causing abnormal thyroid function.(ABSTRACT TRUNCATED AT 250 WORDS)
我们在四项独立研究中评估了外源性给予胰岛素样生长因子-I(IGF-I)对甲状腺轴的影响:(1)静脉推注;(2)单次皮下注射;(3)连续7天皮下给药;(4)连续4个月给药。13例拉伦型侏儒症(LTD)患者参与了研究。在研究1和2中,还纳入了10名健康受试者。在长期治疗前及治疗期间(研究4),6例LTD患者接受了促甲状腺激素释放激素(TRH)试验。IGF-I的给药剂量为静脉注射75微克/千克或皮下注射120 - 150微克/千克。单次注射IGF-I可使LTD患者血清促甲状腺激素(TSH)显著降低(静脉注射:从1.7±0.2降至1.1±0.1 mU/L;皮下注射:从2.1±0.4降至1.1±0.2;p<0.0005)。对照组中,静脉注射从1.2±0.2降至0.8±0.2 mU/L(p<0.02),皮下注射从2.0±0.5降至0.8±0.2 mU/L(p<0.05)。长期给予IGF-I会导致血清TSH和游离甲状腺素(fT4)短暂降低,随后自发回升至治疗前水平甚至更高。未观察到三碘甲状腺原氨酸(T3)有变化。IGF-I治疗4个月后,TRH刺激引起的TSH反应显著增强(p<0.005)。IGF-I的作用可解释为早期刺激生长抑素释放导致TSH降低,随后出现代偿机制。所有变化均在正常范围内,未导致甲状腺功能异常。(摘要截选至250词)