Mauras Nelly, Bishop Kim, Welch Susan
Division of Pediatric Endocrinology and Metabolism, Nemours Children's Clinic, Jacksonville, FL 32207, United States.
Growth Horm IGF Res. 2007 Dec;17(6):463-71. doi: 10.1016/j.ghir.2007.04.011. Epub 2007 Jun 12.
Adult females receiving GH may be less sensitive to the metabolic effects of GH than males, however these differences are less well studied in adolescence. We aimed to investigate if metabolic effects of GH vary by gender during puberty.
Sixteen adolescents (8 M/8 F, mean age (SE): 13.1+/-0.2 yr) with significant short stature due to either GH insufficiency or idiopathic short stature were studied before and after 8 w of daily GH therapy. Differences in rates of protein and glycerol turnover ((13)C leucine and d5-glycerol infusions), substrate oxidation rates (indirect calorimetry), hormones, growth factors, lipid concentrations, body composition (DEXA) and 1 yr growth velocity were measured.
Protein synthesis rates per kg FFM were similar in boys and girls before and after GH and increased similarly on treatment in both genders. Rates of whole body lipolysis were similar at baseline and increased after GH in both genders comparably. Plasma lipids were similar between boys and girls before and after GH, and triglycerides increased post-GH in both. Insulin increased after GH comparably in both genders, yet no significant difference in glucose or adiponectin concentrations during treatment or between genders was observed. IGF-I concentrations were similar between boys and girls at baseline, but with a more robust increase in males after 8 w of GH (boys: +629+/-65 ng/ml, girls: +331+/-67, p=0.007). Body composition changes and bone mineral density were similar between genders after GH. HT SDS increased comparably after 1 yr (boys -2.2+/-0.09 to -1.77+/-0.11, p=0.0002; girls -2.49+/-0.24 to -2.02+/-0.25, p=0.04). There were no gender differences on the linear growth responses after 12 mo.
As compared to girls, boys had: (1) similar sensitivity to GH for protein synthesis, lipolysis, lipid concentrations and body composition changes as well as comparable glucose and adiponectin concentrations; (2) higher IGF-I responses to 8 w of GH. Differences in IGF-I during GH treatment may account in part for the gender differences in physique and strength that develop during human puberty; however, using conventional doses of GH, these differences do not translate into differences in linear growth after 12 mo. Contrary to adults, these data do not support the need for different GH dosing depending on gender during puberty.
接受生长激素（GH）治疗的成年女性对GH的代谢作用可能不如男性敏感，然而在青春期，这些差异的研究较少。我们旨在研究青春期期间GH的代谢作用是否因性别而异。
对16名青少年（8名男性/8名女性，平均年龄（标准误）：13.1±0.2岁）进行研究，这些青少年因GH缺乏或特发性矮小而身材显著矮小，在每日GH治疗8周前后进行观察。测量蛋白质和甘油周转率（（13）C亮氨酸和d5-甘油输注）、底物氧化率（间接测热法）、激素、生长因子、脂质浓度、身体成分（双能X线吸收法）和1年生长速度的差异。
治疗前后，每千克去脂体重的蛋白质合成率在男孩和女孩中相似，且治疗后两性均有相似程度的增加。全身脂肪分解率在基线时相似，GH治疗后两性均有类似增加。GH治疗前后男孩和女孩的血浆脂质相似，且治疗后甘油三酯均升高。GH治疗后两性胰岛素均有类似增加，但治疗期间或两性之间血糖或脂联素浓度无显著差异。基线时男孩和女孩的IGF-I浓度相似，但GH治疗8周后男性的增加更为显著（男孩：+629±65 ng/ml，女孩：+331±67，p = 0.007）。GH治疗后两性的身体成分变化和骨密度相似。1年后身高标准差积分（HT SDS）的增加程度相似（男孩 -2.2±0.09至 -1.77±0.11，p = 0.0002；女孩 -2.49±0.24至 -2.02±0.25，p = 0.04）。12个月后线性生长反应无性别差异。
与女孩相比，男孩：（1）在蛋白质合成、脂肪分解、脂质浓度和身体成分变化以及血糖和脂联素浓度方面对GH的敏感性相似；（2）对8周GH治疗的IGF-I反应更高。GH治疗期间IGF-I的差异可能部分解释了人类青春期期间身体形态和力量方面的性别差异；然而，使用常规剂量的GH，这些差异在12个月后并未转化为线性生长的差异。与成年人相反，这些数据不支持青春期期间根据性别调整GH剂量的必要性。
