Franco Celina, Brandberg John, Lönn Lars, Andersson Björn, Bengtsson Bengt-Ake, Johannsson Gudmundur
Research Centre for Endocrinology and Metabolism, Gröna Stråket 8, Sahlgrenska University Hospital, SE-413 45 Göteborg, Sweden.
J Clin Endocrinol Metab. 2005 Mar;90(3):1466-74. doi: 10.1210/jc.2004-1657. Epub 2004 Dec 14.
Abdominal obesity is associated with blunted GH secretion and a cluster of cardiovascular risk factors that characterize the metabolic syndrome. GH treatment in abdominally obese men reduces visceral adipose tissue and has beneficial effects on the metabolic profile. There are no long-term data on the effects of GH treatment on postmenopausal women with abdominal obesity. Forty postmenopausal women with abdominal obesity participated in a randomized, double-blind, placebo-controlled, 12-month trial with GH (0.67 mg/d). The primary aim was to study the effect of GH treatment on insulin sensitivity. Measurements of glucose disposal rate (GDR) using a euglycemic, hyperinsulinemic glucose clamp; abdominal fat, hepatic fat content, and thigh muscle area using computed tomography; and total body fat and fat-free mass derived from (40)K measurements were performed at baseline and at 6 and 12 months. GH treatment reduced visceral fat mass, increased thigh muscle area, and reduced total and low-density lipoprotein cholesterol compared with placebo. Insulin sensitivity was increased at 12 months compared with baseline values in the GH-treated group. In the GH-treated group only, a low baseline GDR was correlated with a more marked improvement in insulin sensitivity (r = -0.68; P < 0.001). A positive correlation was found between changes in GDR and liver attenuation as a measure of hepatic fat content between baseline and 12 months (r = 0.7; P < 0.001) in the GH-treated group. In postmenopausal women with abdominal obesity, 1 yr of GH treatment improved insulin sensitivity and reduced abdominal visceral fat and total and low-density lipoprotein cholesterol concentrations. The improvement in insulin sensitivity was associated with reduced hepatic fat content.
腹部肥胖与生长激素（GH）分泌迟钝以及一系列代谢综合征所特有的心血管危险因素相关。对腹部肥胖男性进行GH治疗可减少内脏脂肪组织，并对代谢状况产生有益影响。目前尚无关于GH治疗对绝经后腹部肥胖女性影响的长期数据。40名绝经后腹部肥胖女性参与了一项为期12个月的随机、双盲、安慰剂对照试验，接受GH（0.67毫克/天）治疗。主要目的是研究GH治疗对胰岛素敏感性的影响。在基线、6个月和12个月时，采用正常血糖、高胰岛素葡萄糖钳夹技术测量葡萄糖处置率（GDR）；使用计算机断层扫描测量腹部脂肪、肝脏脂肪含量和大腿肌肉面积；并通过（40）K测量得出全身脂肪和去脂体重。与安慰剂相比，GH治疗可减少内脏脂肪量，增加大腿肌肉面积，并降低总胆固醇和低密度脂蛋白胆固醇。与基线值相比，GH治疗组在12个月时胰岛素敏感性增加。仅在GH治疗组中，低基线GDR与胰岛素敏感性更显著改善相关（r = -0.68；P < 0.001）。在GH治疗组中，基线至12个月期间GDR的变化与作为肝脏脂肪含量指标的肝脏衰减之间存在正相关（r = 0.7；P < 0.001）。在绝经后腹部肥胖女性中，1年的GH治疗可改善胰岛素敏感性，减少腹部内脏脂肪以及总胆固醇和低密度脂蛋白胆固醇浓度。胰岛素敏感性的改善与肝脏脂肪含量降低有关。
