Møller J, Jørgensen J O, Møller N, Hansen K W, Pedersen E B, Christiansen J S
University Department of Endocrinology and Internal Medicine, Aarhus Kommunehospital, Denmark.
J Clin Endocrinol Metab. 1991 Apr;72(4):768-72. doi: 10.1210/jcem-72-4-768.
Sodium retention and symptoms and signs of fluid retention are commonly recorded during GH administration in both GH-deficient patients and normal subjects. Most reports have however, been casuistic or uncontrolled. In a randomized double blind placebo-controlled cross-over study we therefore examined the effect of 14-day GH administration (12 IU sc at 2000 h) on plasma volume, extracellular volume (ECV), atrial natriuretic peptide (ANP), arginine vasopressin, and the renin angiotensin system in eight healthy adult men. A significant GH induced increase in serum insulin growth factor I was observed. GH caused a significant increase in ECV (L): 20.45 +/- 0.45 (GH), 19.53 +/- 0.48 (placebo) (P less than 0.01), whereas plasma volume (L) remained unchanged 3.92 +/- 0.16 (GH), 4.02 +/- 0.13 (placebo). A significant decrease in plasma ANP (pmol/L) after GH administration was observed: 2.28 +/- 0.54 (GH), 3.16 +/- 0.53 (placebo) P less than 0.01. Plasma aldosterone (pmol/L): 129 +/- 14 (GH), 89 +/- 17 (placebo), P = 0.08, and plasma angiotensin II (pmol/L) levels: 18 +/- 12 (GH), 14 +/- 7 (placebo), P = 0.21, were not significantly elevated. No changes in plasma arginine vasopressin occurred (1.86 +/- 0.05 pmol/L vs. 1.90 +/- 0.05, P = 0.33). Serum sodium and blood pressure remained unaffected. Moderate complaints, which could be ascribed to water retention, were recorded in four subjects [periorbital edema (n = 3), acral paraesthesia (n = 2) and light articular pain (n = 1)]. The symptoms were most pronounced after 2-3 days of treatment and diminished at the end of the period. In summary, 14 days of high dose GH administration caused a significant increase in ECV and a significant suppression of ANP.
在生长激素缺乏患者和正常受试者中，使用生长激素期间通常会记录钠潴留以及液体潴留的症状和体征。然而，大多数报告都是偶然的或无对照的。因此，在一项随机双盲安慰剂对照交叉研究中，我们研究了8名健康成年男性连续14天使用生长激素（晚上8点皮下注射12国际单位）对血浆容量、细胞外液容量（ECV）、心房利钠肽（ANP）、精氨酸加压素以及肾素-血管紧张素系统的影响。观察到生长激素诱导血清胰岛素样生长因子I显著增加。生长激素导致ECV（升）显著增加：20.45±0.45（生长激素组），19.53±0.48（安慰剂组）（P<0.01），而血浆容量（升）保持不变，分别为3.92±0.16（生长激素组），4.02±0.13（安慰剂组）。观察到使用生长激素后血浆ANP（皮摩尔/升）显著降低：2.28±0.54（生长激素组），3.16±0.53（安慰剂组），P<0.01。血浆醛固酮（皮摩尔/升）：129±14（生长激素组），89±17（安慰剂组），P = 0.08，血浆血管紧张素II（皮摩尔/升）水平：18±12（生长激素组），14±7（安慰剂组），P = 0.21，均未显著升高。血浆精氨酸加压素无变化（1.86±0.05皮摩尔/升对1.90±0.05，P = 0.33）。血清钠和血压未受影响。4名受试者记录到可归因于水潴留的中度不适[眶周水肿（n = 3）、肢端感觉异常（n = 2）和轻度关节疼痛（n = 1）]。症状在治疗2 - 3天后最明显，在疗程结束时减轻。总之，连续14天高剂量使用生长激素导致ECV显著增加和ANP显著抑制。
