Díez Juan J, Cordido Fernando
Servicio de Endocrinología, Hospital Ramón y Cajal, Universidad de Alcalá de Henares, Madrid, España.
Servicio de Endocrinología, Complejo Hospitalario Universitario de A Coruña, Departamento de Medicina, Universidad de A Coruña, A Coruña, España.
Med Clin (Barc). 2014 Oct 21;143(8):354-9. doi: 10.1016/j.medcli.2013.11.026. Epub 2014 Jan 28.
Adult growth hormone (GH) deficiency is a well-recognized clinical syndrome with adverse health consequences. Many of these may improve after replacement therapy with recombinant GH. This treatment induces an increase in lean body mass and a decrease in fat mass. In long-term studies, bone mineral density increases and muscle strength improves. Health-related quality of life tends to increase after treatment with GH. Lipid profile and markers of cardiovascular risk also improve with therapy. Nevertheless, GH replacement therapy is not without risk. According to some studies, GH increases blood glucose, body mass index and waist circumference and may promote long-term development of diabetes and metabolic syndrome. Risk of neoplasia does not appear to be increased in adults treated with GH, but there are some high-risk subgroups. Methodological shortcomings and difficulties inherent to long-term studies prevent definitive conclusions about the relationship between GH and survival. Therefore, research in this field should remain active.
成人生长激素(GH)缺乏是一种公认的临床综合征,会对健康产生不良影响。其中许多影响在接受重组GH替代治疗后可能会有所改善。这种治疗会使瘦体重增加,脂肪量减少。在长期研究中,骨矿物质密度增加,肌肉力量增强。接受GH治疗后,与健康相关的生活质量往往会提高。血脂水平和心血管疾病风险标志物也会随着治疗而改善。然而,GH替代治疗并非没有风险。根据一些研究,GH会升高血糖、体重指数和腰围,并可能促进糖尿病和代谢综合征的长期发展。接受GH治疗的成年人患肿瘤的风险似乎并未增加,但存在一些高危亚组。长期研究中固有的方法学缺陷和困难妨碍了就GH与生存率之间的关系得出明确结论。因此,该领域的研究应继续积极开展。