Chihara K, Kato Y, Kohno H, Takano K, Tanaka T, Teramoto A, Shimatsu A
Division of Endocrinology, Metabolism, Hematology and Oncology, Department of Clinical Molecular Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho Chuo-ku, Kobe 650-0017, Japan.
Growth Horm IGF Res. 2006 Apr;16(2):132-42. doi: 10.1016/j.ghir.2006.03.012. Epub 2006 May 15.
The aim of this study was to assess the effect of growth hormone (GH) replacement therapy on lean body mass (LBM) and other variables including body fat mass, serum lipids and quality of life measures in GH-deficient Japanese adults.
This was a multicentre, double-blind, placebo-controlled, parallel group study. Following initial screening, patients were randomly assigned to GH treatment (n=37) or placebo (n=36). GH treatment was started at an initial dose 0.003 mg/kg/day s.c. each day for the first 4 weeks after which the dose was increased to 0.006 mg/kg/day for 4 weeks and then to 0.012 mg/kg/day for the last 16 weeks (n=37). Body composition, serum lipids, serum IGF-I and IGFBP-3 levels were measured during the 24-week study. Short Form-36 and Quality of Life Assessment of GH Deficiency in Adults scores were also determined.
LBM was significantly increased from baseline at 24 weeks in GH-treated patients, with a mean (+/-SD) increase of 4.7% (+/-5.3%) compared with an increase of 1.0% (+/-4.4%) in the placebo group (p<0.0001 versus baseline, p=0.0003 versus placebo). Percentage body fat decreased significantly from baseline in GH-treated patients (9.3%, p<0.0001), compared with a non-significant 0.2% increase in the placebo group (p<0.0004 for difference between treatment groups). In addition, significantly increased serum IGF-I and IGFBP-3 levels and improvements in the patients' serum lipid profiles were observed in patients who received GH therapy. Changes in quality of life measures did not differ between treatments, probably because of the small number of patients studied. GH therapy was well tolerated, with adverse events of any cause reported in 86.5% of the GH treatment group and 83.3% of the placebo group.
GH treatment significantly improved body composition and serum lipid profiles in adult Japanese patients with GH deficiency compared with placebo and had no clinically relevant adverse effects.
本研究旨在评估生长激素(GH)替代疗法对日本成年生长激素缺乏患者瘦体重(LBM)及其他变量的影响,这些变量包括体脂量、血脂和生活质量指标。
这是一项多中心、双盲、安慰剂对照的平行组研究。初始筛查后,患者被随机分配至GH治疗组(n = 37)或安慰剂组(n = 36)。GH治疗起始剂量为0.003 mg/kg/天,皮下注射,前4周每天如此,之后剂量增加至0.006 mg/kg/天,持续4周,最后16周增至0.012 mg/kg/天(n = 37)。在为期24周的研究中测量身体成分、血脂、血清IGF-I和IGFBP-3水平。还测定了简明健康调查问卷36项(Short Form-36)评分和成人生长激素缺乏症生活质量评估得分。
GH治疗患者在24周时LBM较基线显著增加,平均(±标准差)增加4.7%(±5.3%),而安慰剂组增加1.0%(±4.4%)(与基线相比p < 0.0001,与安慰剂组相比p = 0.0003)。GH治疗患者的体脂百分比较基线显著下降(9.3%,p < 0.0001),而安慰剂组非显著增加0.2%(治疗组间差异p < 0.0004)。此外,接受GH治疗的患者血清IGF-I和IGFBP-3水平显著升高,血脂谱改善。生活质量指标的变化在各治疗组间无差异,可能是因为研究的患者数量较少。GH治疗耐受性良好,GH治疗组86.5%和安慰剂组83.3%报告了任何原因导致的不良事件。
与安慰剂相比,GH治疗显著改善了日本成年生长激素缺乏患者的身体成分和血脂谱,且无临床相关不良反应。