Integrated Department of Medicine, University of Modena and Reggio Emilia, Via Giardini 1355, 41100 Modena, Italy.
Eur J Endocrinol. 2012 Mar;166(3):415-24. doi: 10.1530/EJE-11-0829. Epub 2011 Dec 21.
GH secretion is impaired in lipodystrophic human immunodeficiency virus (HIV) patients and inversely related to lipodystrophy-related fat redistribution in men. Less is known about the underlying mechanisms involved in reduced GH secretion in HIV-infected women.
A case-control, cross-sectional study comparing GH/IGF1 status, body composition, and metabolic parameters in 92 nonobese women with HIV-related lipodystrophy and 63 healthy controls matched for age, ethnicity, sex, and body mass index (BMI).
GH, IGF1, IGF binding protein 3 (IGFBP3), GH after GHRH plus arginine (GHRH+Arg), several metabolic variables, and body composition were evaluated.
GH response to GHRH+Arg was lower in HIV-infected females than in controls. Using a cutoff of peak GH ≤ 7.5 μg/l, 20.6% of HIV-infected females demonstrated reduced peak GH response after GHRH+Arg. In contrast, none of the control subjects demonstrated a peak GH response ≤ 7.5 μg/l. Bone mineral density (BMD), quality of life, IGF1, and IGFBP3 were lowest in the HIV-infected females with a GH peak ≤ 7.5 μg/l. BMI was the main predictive factor of GH peak in stepwise multiregression analysis followed by age, with a less significant effect of visceral fat in the HIV-infected females.
This study establishes that i) GH response to GHRH+Arg is lower in lipoatrophic HIV-infected women than in healthy matched controls, ii) BMI more than visceral adipose tissue or trunk fat influences GH peak in this population, and iii) HIV-infected women with a GH peak below or equal to 7.5 μg/l demonstrate reduced IGF1, IGFBP3, BMD, and quality of life.
脂肪营养不良的人类免疫缺陷病毒 (HIV) 患者的 GH 分泌受损，且与男性脂肪分布异常相关。关于 HIV 感染女性 GH 分泌减少的潜在机制知之甚少。
一项病例对照、横断面研究，比较了 92 例非肥胖 HIV 相关脂肪营养不良女性和 63 例年龄、种族、性别和体重指数（BMI）匹配的健康对照者的 GH/IGF1 状态、身体成分和代谢参数。
评估 GH、IGF1、IGF 结合蛋白 3（IGFBP3）、GH 后 GHRH 加精氨酸（GHRH+Arg）、几种代谢变量和身体成分。
与对照组相比，HIV 感染女性的 GHRH+Arg 后 GH 反应较低。使用峰值 GH≤7.5μg/l 的截止值，20.6%的 HIV 感染女性表现出 GHRH+Arg 后 GH 峰值降低。相比之下，对照组中无一例出现峰值 GH≤7.5μg/l。骨密度（BMD）、生活质量、IGF1 和 IGFBP3 在 GH 峰值≤7.5μg/l 的 HIV 感染女性中最低。BMI 是逐步多元回归分析中 GH 峰值的主要预测因素，其次是年龄，而在 HIV 感染女性中，内脏脂肪的影响较小。
本研究确立了以下几点：i）GHRH+Arg 后 GH 反应在脂肪营养不良的 HIV 感染女性中低于健康匹配的对照组；ii）BMI 比内脏脂肪组织或躯干脂肪对该人群的 GH 峰值影响更大；iii）GH 峰值低于或等于 7.5μg/l 的 HIV 感染女性表现出 IGF1、IGFBP3、BMD 和生活质量降低。
