Tauchmanova L, Di Somma C, Rusciano A, Lombardi G, Colao A
Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, 80131 Naples, Italy.
J Endocrinol Invest. 2007;30(6 Suppl):35-41.
Adults with either GH deficiency (GHD) or GH excess have bone, metabolic, and somatic impairments. This review deals with available data on the relationship between GH status, bone mass, articular disorders, and body composition. GHD subjects have reduced bone mineralization and increased fracture rates. Acromegalic artropathy occurs in virtually all patients and in its late degenerative stages may resemble osteoarthritis. Abnormalities in GH/IGF-I were observed in patients with different forms of arthritis. When concerning body composition (BC), both severe and partial GHD are characterized by increased fat mass, especially truncal, and reduced lean mass. In acromegaly, an increase in body weight, lean mass, and extracellular water, and reduced fat mass were observed; these abnormalities did not always disappear after the normalization of GH/IGF-I levels. On the contrary, long-term GH replacement at physiological doses improved the abnormalities in BC and increased bone mineral density in men with adult-onset GHD, but discordant data were obtained for the bone effects in women. In conclusion, both GHD and GH excess are responsible for some well-defined alterations in metabolism, BC, bone mass, and joint physiology. Their normalization (by GH replacement or treatment of acromegaly) reverses most of these abnormalities, thus confirming their GH-related etiology.
患有生长激素缺乏症（GHD）或生长激素过多的成年人存在骨骼、代谢和身体方面的损伤。本综述探讨了有关生长激素状态、骨量、关节疾病和身体成分之间关系的现有数据。生长激素缺乏症患者的骨矿化减少，骨折率增加。几乎所有肢端肥大症患者都会出现关节病，在其晚期退行性阶段可能类似于骨关节炎。在不同类型关节炎患者中观察到生长激素/胰岛素样生长因子-1（GH/IGF-I）异常。关于身体成分（BC），严重和部分生长激素缺乏症的特征都是脂肪量增加，尤其是躯干脂肪增加，瘦体重减少。在肢端肥大症中，观察到体重、瘦体重和细胞外液增加，脂肪量减少；生长激素/胰岛素样生长因子-1水平恢复正常后，这些异常情况并非总是消失。相反，生理剂量的长期生长激素替代改善了成年发病型生长激素缺乏症男性的身体成分异常，并增加了骨矿物质密度，但在女性的骨骼效应方面获得的数据不一致。总之，生长激素缺乏症和生长激素过多都会导致代谢、身体成分、骨量和关节生理方面的一些明确改变。它们的正常化（通过生长激素替代或肢端肥大症治疗）可逆转这些异常情况中的大多数，从而证实了它们与生长激素相关的病因。
