Abs Roger, Feldt-Rasmussen Ulla, Mattsson Anders F, Monson John P, Bengtsson Bengt-Ake, Góth Miklós I, Wilton Patrick, Koltowska-Häggström Maria
Department of Endocrinology, University Hospital, Antwerp, Belgium.
Eur J Endocrinol. 2006 Jul;155(1):79-90. doi: 10.1530/eje.1.02179.
The aim of the present study was to clarify the relationship between GH deficiency (GHD) and some cardiovascular risk factors and to analyse the effect of GH replacement therapy in a large number of patients over a prolonged period of time.
Data for analysis were retrieved from KIMS (Pfizer International Metabolic Database). Serum concentrations of total cholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides were obtained from 2589 patients at baseline and from 1206 patients after 1 and 2 years of GH replacement therapy. Body mass index (BMI), waist and hip, resting blood pressure and body composition were also measured.
At baseline, the unfavourable effects of GHD were most obvious in the lipid profile demonstrating elevated mean total and LDL-cholesterol, in the increased waist circumference and the elevated BMI. The cholesterol concentration, BMI and body composition were significantly adversely affected by a number of factors, including age, sex and the use of anti-epileptic drugs. The therapeutic effect of GH was essentially uniform across the whole population. GH replacement reduced significantly the mean total and LDL-cholesterol, the waist circumference and the fat mass and was maintained during 2 years.
This analysis of a large number of patients confirmed that GHD adults present with an increased cardiovascular risk. The sustained improvement of the adverse lipid profile and body composition suggests that GH replacement therapy may reduce the risk of cardiovascular disease and the premature mortality seen in hypopituitary patients with untreated GHD.
本研究旨在阐明生长激素缺乏症（GHD）与一些心血管危险因素之间的关系，并分析生长激素替代疗法在大量患者中长期的治疗效果。
分析数据取自KIMS（辉瑞国际代谢数据库）。在基线时获取了2589例患者的总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇和甘油三酯的血清浓度，并在生长激素替代治疗1年和2年后获取了1206例患者的上述数据。还测量了体重指数（BMI）、腰围和臀围、静息血压和身体成分。
在基线时，GHD的不利影响在血脂谱中最为明显，表现为总胆固醇和LDL胆固醇均值升高、腰围增加和BMI升高。胆固醇浓度、BMI和身体成分受到多种因素的显著不利影响，包括年龄、性别和抗癫痫药物的使用。生长激素的治疗效果在整个人群中基本一致。生长激素替代治疗显著降低了总胆固醇和LDL胆固醇的均值、腰围和脂肪量，且在2年内维持该效果。
对大量患者的这项分析证实，患有GHD的成年人心血管风险增加。血脂谱和身体成分的持续改善表明，生长激素替代治疗可能降低心血管疾病风险以及未治疗GHD的垂体功能减退患者的过早死亡率。
