Christ Emanuel R, Cummings Michael H, Stolinski Michael, Jackson Nicola, Lumb Peter J, Wierzbicki Anthony S, Sönksen Peter H, Russell-Jones David L, Umpleby A Margot
Department of Endocrinology and Diabetology, University Hospital of Bern, Switzerland.
Eur J Endocrinol. 2006 Mar;154(3):459-66. doi: 10.1530/eje.1.02105.
Epidemiological studies suggest that hypopituitary patients have an increased risk for cardiovascular mortality. The dyslipidaemia associated with this condition is often characterised by an increase in total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol (LDL-C) and may contribute to these findings. The underlying mechanisms are not fully elucidated.
LDL apolipoprotein B (apoB) production rate and metabolic clearance rate were measured in seven patients with hypopituitarism (including GH deficiency) under stable conventional replacement therapy (three males and four females; age 40-16.1 years; body mass index 29.0-6.1 kg/m(2) (means +/- s.d.)) and seven age-, gender- and body mass index-matched control subjects with an infusion of 1-(13)C-leucine. Fasting lipid profile and lipid composition of LDL were also measured.
Fasting TC, triglycerides (TG), high-density lipoprotein-C, LDL-C and free fatty acid concentrations were not different between hypopituitary patients and control subjects. LDL-TG (P < 0.006) and LDL-TG/LDL apoB ratio (P < 0.02) were significantly increased in hypopituitary patients. LDL apoB pool size was not statistically different between patients and control subjects. In the hypopituitary patients, LDL apoB metabolic clearance rate (P < 0.05) and LDL apoB production rate (P < 0.02) were lower than in the control subjects.
The present results suggest that LDL apoB turnover and LDL composition is altered in hypopituitary patients. Whether these findings explain the increased risk for cardiovascular disease in hypopituitary patients remains to be established.
流行病学研究表明，垂体功能减退患者心血管疾病死亡率增加。与该病症相关的血脂异常通常表现为总胆固醇（TC）和低密度脂蛋白（LDL）胆固醇（LDL-C）升高，这可能是导致上述结果的原因之一。其潜在机制尚未完全阐明。
对7例接受稳定常规替代治疗的垂体功能减退患者（包括生长激素缺乏患者）（3例男性和4例女性；年龄40 - 16.1岁；体重指数29.0 - 6.1 kg/m²（均值±标准差））和7例年龄、性别及体重指数匹配的对照受试者输注1 - （13）C - 亮氨酸，测量LDL载脂蛋白B（apoB）生成率和代谢清除率。同时测量空腹血脂谱及LDL的脂质组成。
垂体功能减退患者与对照受试者的空腹TC、甘油三酯（TG）、高密度脂蛋白 - C、LDL - C和游离脂肪酸浓度无差异。垂体功能减退患者的LDL - TG（P < 0.006）和LDL - TG/LDL apoB比值（P < 0.02）显著升高。患者与对照受试者之间的LDL apoB池大小无统计学差异。垂体功能减退患者的LDL apoB代谢清除率（P < 0.05）和LDL apoB生成率（P < 0.02）低于对照受试者。
目前结果表明，垂体功能减退患者的LDL apoB周转率和LDL组成发生改变。这些发现是否能解释垂体功能减退患者心血管疾病风险增加仍有待确定。
