Department of Endocrinology, Hospital A Coruña, 15006 A Coruña, Spain.
Mediators Inflamm. 2010;2010:434562. doi: 10.1155/2010/434562. Epub 2010 Jan 21.
The aim of the present study was to evaluate the relationship between GHRH-induced GH secretion in obese premenopausal women and cardiovascular risk markers or insulin resistance. Premenopausal obese women, aged 35-52 years, were studied. GH secretion, IGF-I, serum cardiovascular risk markers, insulin, leptin, mid-waist and hip circumference, total body fat, and truncal fat were measured. Subjects were classified as meeting the criteria for GH deficiency (GHD) when peak GH after stimulation with GHRH was <or=3 microg/L. Mean total and LDL cholesterol, fasting insulin, and HOMA-IR were all higher, in subjects who would have been classified as GH-deficient compared with GH-sufficient. Peak GH secretion after stimulation was inversely associated with fasting insulin (R = -0.650, P = .012), HOMA-IR (R = -0.846, P = .001), total cholesterol (R = -0.532, P = .034), and LDL cholesterol (R = -0.692, P = .006) and positively associated with HDL cholesterol (R = 0.561, P = .037). These data strongly suggest a role for insulin resistance in the decreased GH secretion of obesity and that the blunted GH secretion of central obesity could be the pituitary expression of the metabolic syndrome.
本研究旨在评估肥胖绝经前妇女中 GHRH 诱导的 GH 分泌与心血管风险标志物或胰岛素抵抗之间的关系。研究了年龄在 35-52 岁的肥胖绝经前妇女。测量了 GH 分泌、IGF-I、血清心血管风险标志物、胰岛素、瘦素、腰部和臀部周长、全身脂肪和躯干脂肪。当 GHRH 刺激后 GH 峰值<3μg/L 时,受试者被归类为符合 GH 缺乏(GHD)标准。与 GH 充足的受试者相比,总胆固醇和 LDL 胆固醇、空腹胰岛素和 HOMA-IR 更高。刺激后 GH 分泌峰值与空腹胰岛素呈负相关(R = -0.650,P =.012),与 HOMA-IR 呈负相关(R = -0.846,P =.001),与总胆固醇呈负相关(R = -0.532,P =.034),与 LDL 胆固醇呈负相关(R = -0.692,P =.006),与 HDL 胆固醇呈正相关(R = 0.561,P =.037)。这些数据强烈表明胰岛素抵抗在肥胖者 GH 分泌减少中起作用,而中枢性肥胖的 GH 分泌减弱可能是代谢综合征的垂体表现。