Department of Endocrinology, Christie Hospital NHS Trust, Manchester, UK.
Clin Endocrinol (Oxf). 2010 Oct;73(4):508-15. doi: 10.1111/j.1365-2265.2009.03754.x.
To quantify the relative prevalence of surrogate markers of vascular risk in adults with partial GH deficiency (GH insufficiency, GHI).
Hypopituitary adults with untreated GH deficiency (GHD) have an excess vascular mortality and demonstrate clustering of adverse vascular risk factors. The vascular risk profile of GHI adults has yet to be comprehensively studied.
A cross-sectional case controlled study.
Thirty GHD adults, 24 GHI, and 30 age- and sex-matched controls. GHI adults were defined biochemically using two GH stimulation tests (peak GH 3-7 μg/l).
Serum lipids and apolipoproteins, plasminogen activator inhibitor type-I (PAI-I), C-reactive protein (CRP), lipoprotein (a) [Lp(a)], fibrinogen, blood pressure and carotid intima-medial thickness (IMT).
IGF-I levels of GHI adults were lower than controls (373 ± 123 vs 295 ± 104 μg/l; P < 0.001). Total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) values were consistently between those of, but not significantly different from, GHD and control subjects. GHI adults showed significantly elevated PAI-I levels [80 (13-98) vs 50.5 (3-98) ng/ml; P = 0.01], although no there were differences in CRP, Lp(a), and fibrinogen levels compared with control subjects. No differences in systolic or diastolic blood pressure were shown between study groups. In parallel with the increased vascular risk profile of GH-insufficient adults, carotid IMT was significantly increased (0.503 ± 0.08 vs 0.578 ± 0.130 mm; P = 0.02). TC, LDL-C, Waist-Hip Ratio (WHR), truncal fat mass, and IMT correlated with IGF-I levels and GH status. TG, K(ITT), and PAI-I additionally correlated with GH status, but not with IGF-I levels.
GHI adults are at elevated vascular risk, reflected by adverse surrogate markers and increased carotid IMT. The surrogate risk marker profile parallels GHD adults, but is less divergent from that observed in healthy individuals. No data are yet available as to whether these anomalies will be reflected in an increased vascular mortality in GHI adults.
定量评估部分生长激素缺乏症（GH 不足，GHI）成年人中血管风险替代标志物的相对流行率。
未经治疗的生长激素缺乏症（GHD）的垂体功能减退症成年人的血管死亡率过高，并表现出不良血管危险因素的聚集。GHI 成年人的血管风险状况尚未得到全面研究。
一项横断面病例对照研究。
30 名 GHD 成年人、24 名 GHI 成年人和 30 名年龄和性别匹配的对照者。GHI 成年人通过两项生长激素刺激试验（峰值 GH 3-7μg/l）进行生化定义。
血清脂质和载脂蛋白、纤溶酶原激活物抑制剂-1（PAI-1）、C 反应蛋白（CRP）、脂蛋白（a）[Lp(a)]、纤维蛋白原、血压和颈动脉内膜中层厚度（IMT）。
GHI 成年人的 IGF-I 水平低于对照组（373±123 vs 295±104μg/l；P＜0.001）。总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）和甘油三酯（TG）值均介于 GHD 组和对照组之间，但无显著差异。GHI 成年人的 PAI-1 水平显著升高[80（13-98）vs 50.5（3-98）ng/ml；P=0.01]，尽管与对照组相比，CRP、Lp(a)和纤维蛋白原水平无差异。各组之间的收缩压或舒张压无差异。与 GH 不足成年人的血管风险增加情况一致，颈动脉 IMT 显著增加（0.503±0.08 vs 0.578±0.130mm；P=0.02）。TC、LDL-C、腰臀比（WHR）、躯干脂肪量和 IMT 与 IGF-I 水平和 GH 状态相关。TG、KITT 和 PAI-1 还与 GH 状态相关，但与 IGF-I 水平无关。
GHI 成年人处于升高的血管风险中，反映在不良的替代标志物和增加的颈动脉 IMT 上。替代风险标志物的情况与 GHD 成年人相似，但与健康个体的差异较小。目前尚无数据表明这些异常是否会导致 GHI 成年人的血管死亡率增加。
