严重心力衰竭中的生长激素抵抗在心脏移植后得以解决。
Growth hormone resistance in severe heart failure resolves after cardiac transplantation.
作者信息
Lund Lars H, Freda Pamela, Williams Jill J, LaManca John J, LeJemtel Thierry H, Mancini Donna M
机构信息
Department of Cardiology, Karolinska University Hospital, N305, Stockholm, Sweden.
出版信息
Eur J Heart Fail. 2009 May;11(5):525-8. doi: 10.1093/eurjhf/hfp044. Epub 2009 Apr 19.
AIMS
Severe heart failure (HF) is associated with cachexia; this is often reversed post cardiac transplantation (HTx) with frequent development of obesity. Growth hormone (GH) resistance is common in HF and may contribute to cachexia. Whether GH resistance resolves post HTx is unknown. We aimed to confirm that HF is associated with GH resistance and to test the hypothesis that GH resistance resolves post HTx.
METHODS AND RESULTS
We measured GH, insulin-like growth factor-1 (IGF-1), and body composition in 10 HF patients awaiting HTx, in 18 patients 11 +/- 8 months post HTx, and seven controls. Body mass index was 23.5 +/- 3.2 in HF patients and 29.3 +/- 5.7 post HTx. HTx patients had gained 14 +/- 8 kg since HTx. GH was elevated in HF (control: 0.21 +/- 0.25; HF: 1.13 +/- 1.19; HTx: 0.11 +/- 0.13 ng/mL; P < 0.007), while IGF-1 was higher in HTx (control: 114 +/- 57; HF: 94 +/- 52; HTx: 190 +/- 106 ng/mL; P < 0.02). HTx had higher total body and abdominal fat %.
CONCLUSION
GH resistance is present in severe HF and resolves post HTx. These findings should be confirmed through larger trials.
目的
严重心力衰竭（HF）与恶病质相关；心脏移植（HTx）后这种情况常得到逆转，且肥胖频繁出现。生长激素（GH）抵抗在HF中常见，可能导致恶病质。HTx后GH抵抗是否缓解尚不清楚。我们旨在证实HF与GH抵抗相关，并检验HTx后GH抵抗得到缓解的假设。
方法与结果
我们测量了10例等待HTx的HF患者、18例HTx后11±8个月的患者以及7例对照者的GH、胰岛素样生长因子-1（IGF-1）和身体组成。HF患者的体重指数为23.5±3.2，HTx后为29.3±5.7。自HTx以来，HTx患者体重增加了14±8kg。HF患者的GH升高（对照：0.21±0.25；HF：1.13±1.19；HTx：0.11±0.13ng/mL；P<0.007），而HTx患者的IGF-1更高（对照：114±57；HF：94±52；HTx：190±106ng/mL；P<0.02）。HTx患者的全身和腹部脂肪百分比更高。
结论
严重HF中存在GH抵抗，HTx后可缓解。这些发现应通过更大规模的试验予以证实。
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