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短期给予重组人生长激素对老年人的影响。

Effects of short term administration of recombinant human growth hormone to elderly people.

作者信息

Marcus R, Butterfield G, Holloway L, Gilliland L, Baylink D J, Hintz R L, Sherman B M

机构信息

Aging Study Unit, Veterans Administration Medical Center, Palo Alto, California 94034.

出版信息

J Clin Endocrinol Metab. 1990 Feb;70(2):519-27. doi: 10.1210/jcem-70-2-519.

Abstract

We evaluated the effects of recombinant human GH (rhGH) in 16 men and women more than 60 yr of age. After 10 days of dietary equilibration and control collections, subjects were randomly assigned to receive 0.03, 0.06, or 0.12 mg/kg rhGH by daily injection for 7 days. A brisk rise in circulating somatomedin-C (insulin-like growth factor-I) occurred in all subjects, and this rise was dose dependent. rhGH produced striking changes in nitrogen retention, sodium excretion, and the parathyroid-vitamin D axis. Twenty-four-hour urinary nitrogen excretion decreased from 8.00 +/- 0.33 to 5.01 +/- 0.33 g (P less than 0.001), and sodium excretion decreased from 45.9 +/- 2.96 to 21.2 +/- 3.48 mmol/day (P less than 0.001). Serum calcium concentrations did not change, but serum inorganic phosphorus levels of 1.08 +/- 0.04 mmol/L at baseline increased significantly after rhGH treatment to 1.33 +/- 0.04 mmol/L (P less than 0.001). Increases were also observed in circulating PTH (53.2 +/- 6 vs. 39.5 +/- 4.2 ng/L; P less than 0.01) and calcitriol (82.8 vs. 65.8 pmol/L; P less than 0.05). A rise in serum osteocalcin (10.3 +/- .86 vs. 8.0 +/- 0.5 micrograms/L; P less than 0.05) was accompanied by increased urinary excretion of hydroxyproline (628 +/- 63 vs. 406 +/- 44 mumol/day; P less than 0.01). Despite the reduction in sodium excretion, marked increases were observed in urinary calcium (6.04 +/- 0.97 vs. 3.27 +/- 0.40 mmol/day; P less than 0.01). rhGH significantly impaired oral glucose tolerance and reduced insulin sensitivity, but was otherwise well tolerated and produced no systematic changes in weight or blood pressure. The results of this study indicate that rhGH requires further study as a potential agent for attenuating or reversing the loss of muscle and bone in elderly people.

摘要

我们评估了重组人生长激素(rhGH)对16名60岁以上男性和女性的影响。在进行10天的饮食平衡和对照样本采集后,受试者被随机分配,每天注射0.03、0.06或0.12mg/kg的rhGH,共注射7天。所有受试者的循环生长调节素C(胰岛素样生长因子-I)均迅速升高,且这种升高呈剂量依赖性。rhGH在氮潴留、钠排泄以及甲状旁腺-维生素D轴方面产生了显著变化。24小时尿氮排泄量从8.00±0.33g降至5.01±0.33g(P<0.001),钠排泄量从45.9±2.96mmol/天降至21.2±3.48mmol/天(P<0.001)。血清钙浓度未发生变化,但基线时为1.08±0.04mmol/L的血清无机磷水平在rhGH治疗后显著升高至1.33±0.04mmol/L(P<0.001)。循环中的甲状旁腺激素(PTH)(53.2±6对39.5±4.2ng/L;P<0.01)和骨化三醇(82.8对65.8pmol/L;P<0.05)也有所增加。血清骨钙素升高(10.3±0.86对8.0±0.5μg/L;P<0.05)的同时,尿羟脯氨酸排泄增加(628±63对406±44μmol/天;P<0.01)。尽管钠排泄减少,但尿钙显著增加(6.04±0.97对3.27±0.40mmol/天;P<0.01)。rhGH显著损害口服葡萄糖耐量并降低胰岛素敏感性,但在其他方面耐受性良好,且未引起体重或血压的系统性变化。本研究结果表明,rhGH作为一种潜在药物,用于减轻或逆转老年人肌肉和骨骼流失,还需要进一步研究。

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