Sze Lisa, Neidert Marian C, Bernays René L, Zwimpfer Cornelia, Wiesli Peter, Haile Sarah R, Brändle Michael, Schmid Christoph
Division of Endocrinology and Diabetes, University Hospital, Zurich, Switzerland; Division of Endocrinology and Diabetes, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Clin Endocrinol (Oxf). 2014 Jun;80(6):869-73. doi: 10.1111/cen.12385. Epub 2014 Jan 10.
In acromegaly, disease activity is biochemically assessed by growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels. However, they are often discrepant, as several factors including gender influence their relationship. We recently found excessively high serum levels of soluble Klotho (sKl) in acromegalic patients, which depended on GH to a comparable extent as IGF-1. To further elucidate the relationship between GH and sKl, we examined the effect of gender on sKl in patients with untreated acromegaly.
We determined GH, IGF-1 and sKl in sera of 62 consecutive patients with newly diagnosed acromegaly (31 females/31 males, aged 20-85 years).
For their given GH excess at presentation with acromegaly, females had lower IGF-1 (490 ± 33 vs 604 ± 33 ng/ml, P = 0·02), but higher sKl [5171 ± 590 vs 3439 ± 431 pg/ml (mean ± SE), P = 0·02] levels than males. In multiple regression analysis, IGF-1 was closely associated with logGH (estimate 139, SE 47, P = 0·005) and BMI (estimate 14·2, SE 4·8, P = 0·005). sKl was closely associated with logGH (estimate 3088, SE 652, P = 0·0001) and gender (estimate 2034, SE 612, P = 0·002), and to a lesser extent with BMI (estimate 174, SE 66, P = 0·01).
For a given GH status, sKl concentrations are higher and IGF-1 concentrations are lower in women than in men. GH is the strongest predictor for both sKl and IGF-1, but gender needs to be considered when using these parameters for monitoring acromegalic patients.
在肢端肥大症中，通过生长激素（GH）和胰岛素样生长因子-1（IGF-1）水平对疾病活动进行生化评估。然而，它们常常不一致，因为包括性别在内的几个因素会影响它们之间的关系。我们最近发现肢端肥大症患者血清中可溶性Klotho（sKl）水平过高，其依赖GH的程度与IGF-1相当。为了进一步阐明GH与sKl之间的关系，我们研究了性别对未经治疗的肢端肥大症患者sKl的影响。
我们测定了62例新诊断的肢端肥大症患者（31例女性/31例男性，年龄20 - 85岁）血清中的GH、IGF-1和sKl。
在肢端肥大症初诊时，对于相同程度的GH过量，女性的IGF-1水平较低（490±33 vs 604±33 ng/ml，P = 0.02），但sKl水平较高[5171±590 vs 3439±431 pg/ml（均值±标准误），P = 0.02]。在多元回归分析中，IGF-1与logGH密切相关（估计值139，标准误47，P = 0.005）和BMI（估计值14.2，标准误4.8，P = 0.005）。sKl与logGH密切相关（估计值3088，标准误652，P = 0.0001）和性别（估计值2034，标准误612，P = 0.002），与BMI的相关性较小（估计值174，标准误66，P = 0.01）。
对于给定的GH状态，女性的sKl浓度高于男性，IGF-1浓度低于男性。GH是sKl和IGF-1的最强预测因子，但在使用这些参数监测肢端肥大症患者时需要考虑性别因素。
