Walker J M, Bond S A, Voss L D, Betts P R, Wootton S A, Jackson A A
Department of Paediatrics, Southampton General Hospital, UK.
Lancet. 1990 Dec 1;336(8727):1331-4. doi: 10.1016/0140-6736(90)92891-k.
41 short normal children were randomly allocated either to daily injections of growth hormone (rhGH) at 30 IU/m2 per week or to no treatment. 6 months of rhGH therapy produced up to 76% loss of fat mass and up to 25% increase in lean body mass (LBM). These changes were significantly different from those in the untreated group. LBM was the main determinant of resting energy expenditure (REE) expressed as kJ/24 h. REE expressed as kJ/kg LBM per 24 h correlated negatively with height, which was responsible for 66% of the variance in REE kJ/kg LBM per 24 h. Short children therefore expend more energy than tall children in fulfilling basic metabolic needs. After 6 months REE kJ/24 h increased significantly in treated children. However, treated children did not differ significantly from untreated children in REE kJ/kg LBM per 24 h. rhGH does not therefore seem to have a specific effect upon REE. The possibility that rhGH produces profound metabolic effects should limit its use in otherwise healthy children until the mechanism of action is more clearly elucidated.
41名身材矮小的正常儿童被随机分为两组，一组每周接受30 IU/m²的生长激素（rhGH）每日注射治疗，另一组不接受治疗。6个月的rhGH治疗使脂肪量减少高达76%，瘦体重（LBM）增加高达25%。这些变化与未治疗组有显著差异。LBM是静息能量消耗（REE，以kJ/24小时表示）的主要决定因素。以kJ/kg LBM每24小时表示的REE与身高呈负相关，身高解释了每24小时kJ/kg LBM的REE中66%的变异。因此，身材矮小的儿童在满足基本代谢需求时比身材高大的儿童消耗更多能量。6个月后，接受治疗的儿童的REE kJ/24小时显著增加。然而，在每24小时kJ/kg LBM的REE方面，接受治疗的儿童与未治疗的儿童没有显著差异。因此，rhGH似乎对REE没有特定影响。在作用机制更清楚之前，rhGH产生深远代谢影响的可能性应限制其在其他方面健康的儿童中的使用。
