Department of Endocrinology4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, IndiaInternal MedicineCardiologyHematologyHistopathologyGastroenterologyNeurosurgeryPharmacologyRadiodiagnosisPost Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Department of Endocrinology4th Floor, F Block, Post Graduate Institute of Medical Education and Research, Nehru Hospital, Chandigarh 160012, IndiaInternal MedicineCardiologyHematologyHistopathologyGastroenterologyNeurosurgeryPharmacologyRadiodiagnosisPost Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Endocr Connect. 2015 Mar;4(1):65-75. doi: 10.1530/EC-14-0132. Epub 2015 Jan 19.
The effectiveness and short-term safety of recombinant human GH (r-hGH) in acromegaly patients with GH deficiency (GHD) after treatment are not well established. The study includes ten subjects with acromegaly who had GHD treated with r-hGH for 6 months. Control groups consisted of ten age-, gender-, and BMI-matched healthy subjects and ten active acromegaly patients who were treatment naïve. Body composition, quality of life (QoL), muscle strength, lipid profile, and cardiovascular risk factors were assessed in all subjects at baseline, and the same parameters were reassessed after 6 months of therapy with r-hGH in acromegaly with GHD. Repeat magnetic resonance imaging of the sella was performed in treated subjects. Optical colonoscopy was done and biopsies were taken from multiple sites for proliferation indices (Ki67). The median duration of GHD was 17.8 months and dose of r-hGH administered was 5.7±1.5 μg/kg per day. There was improvement in bone mineral content (P=0.01), bone mineral density (P=0.04), muscle strength (P<0.001), total cholesterol (P=0.003), high-density cholesterol (P<0.001), and QoL - score (P=0.005), and reduction in low-density cholesterol (P=0.003) and triglyceride (P=0.004) after treatment. There was no change in lean body mass, total body fat, hsCRP, lipoprotein (a), and fibrinogen levels. There was a modest increase in plasminogen activator inhibitor 1 (P=0.002), but it was lower compared with healthy controls and treatment naïve acromegalics (P=0.007). Six month-r-hGH therapy improves body composition, atherogenic lipid profile, QoL, and muscle strength in GHD patients who had acromegaly. Long-term prospective studies are needed to evaluate the effect of r-hGH therapy in these patients.
在接受治疗后,生长激素缺乏(GHD)的肢端肥大症患者中,重组人生长激素(r-hGH)的有效性和短期安全性尚未得到充分证实。本研究纳入了 10 例接受 r-hGH 治疗 6 个月的 GHD 肢端肥大症患者。对照组包括 10 例年龄、性别和 BMI 匹配的健康受试者和 10 例初治活动性肢端肥大症患者。所有受试者在基线时评估身体成分、生活质量(QoL)、肌肉力量、血脂谱和心血管危险因素,在接受 r-hGH 治疗 6 个月后对 GHD 肢端肥大症患者的相同参数进行重新评估。对治疗患者重复进行鞍磁共振成像。对所有患者进行光学结肠镜检查,并从多个部位进行活检以检测增殖指数(Ki67)。GHD 的中位持续时间为 17.8 个月,r-hGH 的给药剂量为 5.7±1.5μg/kg/天。治疗后骨矿物质含量(P=0.01)、骨密度(P=0.04)、肌肉力量(P<0.001)、总胆固醇(P=0.003)、高密度胆固醇(P<0.001)和 QoL 评分(P=0.005)均有改善,低密度胆固醇(P=0.003)和甘油三酯(P=0.004)降低。瘦体重、总体脂肪、hsCRP、脂蛋白(a)和纤维蛋白原水平无变化。纤溶酶原激活物抑制剂 1(P=0.002)略有增加,但与健康对照组和初治肢端肥大症患者相比仍较低(P=0.007)。6 个月 r-hGH 治疗可改善 GHD 肢端肥大症患者的身体成分、动脉粥样硬化血脂谱、QoL 和肌肉力量。需要进行长期前瞻性研究来评估 r-hGH 治疗对这些患者的影响。