Mann D R, Rudman C G, Akinbami M A, Gould K G
Morehouse School of Medicine, Atlanta, Georgia.
J Clin Endocrinol Metab. 1992 Jun;74(6):1263-9. doi: 10.1210/jcem.74.6.1592869.
This study examined the effect of human recombinant GH supplementation on bone loss in female monkeys made hypogonadal with GnRH agonist (GnRH-Ag). Animals were randomly assigned to three treatment groups: vehicle, GnRH-Ag, and GnRH-Ag and GH. After an initial 5-month pretreatment period during which all animals were maintained on a normal monkey chow diet containing a high level of calcium (1%) animals were maintained on a normal monkey chow diet containing a high level of calcium (1%), animals were shifted to a lower calcium diet (0.1%) for 4 to 5 months before the beginning of treatment and were maintained on this diet throughout the remainder of the study. Monkeys were treated continuously for 10 months with 25 micrograms/day GnRH-Ag or vehicle. GH was administered by im injection three times per week at a dose of 100 micrograms/kg body wt/day. Animals treated with GnRH-Ag were amenorrheic throughout the treatment period, and serum estradiol and progesterone levels were below minimum levels of detection. Vehicle-treated animals continued to cycle throughout the study. Monkeys treated with GnRH-Ag alone showed a significant decline (12%) in bone mineral density (BMD) of the lumbar spine. BMD was reduced below pretreatment levels from 6 months of GnRH-Ag treatment through 3 months post treatment in this group. GH supplementation reduced the decline of BMD in GnRH-Ag-treated monkeys. BMD did not change significantly with time in the GH-supplemented group. BMD values in GH supplemented animals between 5 and 10 months of the treatment period exceeded levels in animals treated with GnRH-Ag alone, but BMD levels during this interval were lower than in the vehicle-treated group. In the vehicle-treated group, there was small, but significant, increase in BMD over the course of the study. Serum osteocalcin concentrations were elevated above pretreatment values after 6 and 9 months of GnRH-Ag treatment alone or with GH supplementation, but did not change in vehicle-treated animals. GH also increased serum insulin-like growth factor 1 levels. In response to the lower calcium diet, serum PTH levels increased approximately 200% in vehicle-treated monkeys and animals treated with GnRH-Ag alone. GH attenuated this increase in serum PTH. The data indicate that the level of calcium in the diet of adult monkeys can be reduced more than 10-fold without affecting lumbar BMD provided ovarian function is normal, but if animals are made hypogonadal with a GnRH-Ag, bone mass declines.(ABSTRACT TRUNCATED AT 400 WORDS)
本研究检测了补充重组人生长激素(GH)对用促性腺激素释放激素激动剂(GnRH-Ag)使性腺功能减退的雌性猴子骨质流失的影响。动物被随机分为三个治疗组:赋形剂组、GnRH-Ag组以及GnRH-Ag和GH组。在最初5个月的预处理期内,所有动物均维持在含高钙(1%)的正常猴粮饮食上,之后在治疗开始前4至5个月,动物被转换为低钙饮食(0.1%),并在研究的剩余时间内维持该饮食。猴子连续10个月接受每天25微克的GnRH-Ag或赋形剂治疗。GH通过肌肉注射给药,每周三次,剂量为100微克/千克体重/天。用GnRH-Ag治疗的动物在整个治疗期间闭经,血清雌二醇和孕酮水平低于检测下限。用赋形剂治疗的动物在整个研究期间持续有月经周期。单独用GnRH-Ag治疗的猴子腰椎骨矿物质密度(BMD)显著下降(12%)。在该组中,从GnRH-Ag治疗6个月至治疗后3个月,BMD降至预处理水平以下。补充GH减少了GnRH-Ag治疗的猴子BMD的下降。在补充GH的组中,BMD随时间无显著变化。在治疗期5至10个月期间,补充GH的动物的BMD值超过单独用GnRH-Ag治疗的动物,但此期间的BMD水平低于用赋形剂治疗的组。在用赋形剂治疗的组中,在研究过程中BMD有小幅度但显著的增加。单独用GnRH-Ag治疗或联合补充GH治疗6个月和9个月后,血清骨钙素浓度高于预处理值,但在用赋形剂治疗的动物中未发生变化。GH还增加了血清胰岛素样生长因子1水平。对低钙饮食的反应,在用赋形剂治疗的猴子和单独用GnRH-Ag治疗的动物中,血清甲状旁腺激素(PTH)水平增加了约200%。GH减弱了血清PTH的这种增加。数据表明,如果卵巢功能正常,成年猴子饮食中的钙水平可降低10倍以上而不影响腰椎BMD,但如果用GnRH-Ag使动物性腺功能减退,则骨量会下降。(摘要截短至400字)