Gordon Michael S, Caston-Balderrama Anne L, Gordon Murray B
Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Growth Horm IGF Res. 2005 Aug;15(4):251-5. doi: 10.1016/j.ghir.2005.04.002.
Growth hormone deficiency (GHD) is associated with increased premature cardiovascular (CV) mortality. Abnormal cardiac structure and function, including autonomic adrenergic dysfunction as detected by heart rate variability analysis, have been described in GHD. Abnormal prorenin processing resulting in a reduced renin/prorenin ratio has been correlated with cardiac autonomic dysfunction, an established risk factor for CV mortality, in diabetic patients. We investigated renin/prorenin ratios in untreated GHD patients (n=31) and in a group of GHD patients treated with GH (n=23) and compared both groups to a group of 59 normal control subjects. The treated GHD group was replaced with GH for a mean duration of 49.4+/-6.7 months. The mean renin/prorenin ratios were 0.0765+/-0.0089 in the untreated GHD group, 0.113+/-0.018 in the treated GHD group, and 0.304+/-0.029 in the control group (P<0.01, untreated GHD or treated GHD vs. normal controls; P=NS, untreated GHD vs. treated GHD). These results demonstrate that GHD is characterized by abnormal prorenin processing implicating concomitant cardiac autonomic adrenergic dysfunction, a risk factor for increased CV mortality. GH treatment resulted in a non-significant trend towards normalizing this defect.
生长激素缺乏症（GHD）与心血管（CV）过早死亡风险增加相关。GHD患者存在心脏结构和功能异常，包括通过心率变异性分析检测到的自主肾上腺素能功能障碍。在糖尿病患者中，异常的肾素原加工导致肾素/肾素原比值降低，这与心脏自主神经功能障碍相关，而心脏自主神经功能障碍是CV死亡的既定危险因素。我们研究了未经治疗的GHD患者（n = 31）和一组接受生长激素（GH）治疗的GHD患者（n = 23）的肾素/肾素原比值，并将两组与59名正常对照受试者进行比较。接受治疗的GHD组接受GH替代治疗的平均时长为49.4±6.7个月。未经治疗的GHD组平均肾素/肾素原比值为0.0765±0.0089，接受治疗的GHD组为0.113±0.018，对照组为0.304±0.029（未经治疗的GHD组或接受治疗的GHD组与正常对照组相比，P<0.01；未经治疗的GHD组与接受治疗的GHD组相比，P=无显著性差异）。这些结果表明，GHD的特征是肾素原加工异常，伴有心脏自主肾上腺素能功能障碍，这是CV死亡风险增加的一个危险因素。GH治疗使这种缺陷趋于正常化，但无显著趋势。
