Sönksen P H, Salomon F, Cuneo R
Department of Endocrinology and Chemical Pathology, United Medical & Dental School, Guy's Hospital, London, UK.
Horm Res. 1991;36 Suppl 1:27-31. doi: 10.1159/000182184.
Hypopituitarism is associated with reduced lean body mass and increased body fat, while in acromegaly the converse is true. Fasting plasma glucose is increased in acromegaly but fasting plasma insulin and C-peptide are increased in both groups. There is a positive association between fat mass and fasting serum insulin in hypopituitarism, suggesting insulin resistance. Hypoglycaemia unresponsiveness, rather than insulin sensitivity, is the feature of growth hormone deficiency. Basal metabolic rate (expressed per kg body weight) is increased in acromegaly and decreased in hypopituitarism but when expressed 'per kg lean body mass', is increased in both groups. There is a close correlation between fat mass and fasting free fatty acid and glycerol levels in obese but not normal weight patients with hypopituitarism; slim patients appear to metabolise and oxidise their fat stores more effectively than those who remain obese. Thus indirect evidence suggests that growth hormone has an important role in maintaining normal body composition and energy stores.
垂体功能减退与瘦体重减少和体脂增加有关，而在肢端肥大症中情况则相反。肢端肥大症患者的空腹血糖升高，但两组患者的空腹血浆胰岛素和C肽均升高。垂体功能减退患者的体脂与空腹血清胰岛素之间存在正相关，提示胰岛素抵抗。低血糖无反应性而非胰岛素敏感性是生长激素缺乏的特征。肢端肥大症患者的基础代谢率（按每千克体重计算）升高，垂体功能减退患者则降低，但按“每千克瘦体重”计算时，两组患者的基础代谢率均升高。垂体功能减退的肥胖患者而非正常体重患者的体脂与空腹游离脂肪酸和甘油水平密切相关；体型苗条的患者似乎比肥胖患者更有效地代谢和氧化脂肪储备。因此，间接证据表明生长激素在维持正常身体组成和能量储备方面具有重要作用。
