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由于生长激素释放激素受体(GHRHR)无效突变而导致孤立性生长激素缺乏的受试者,其饮食比例比对照组更高,但比对照组更健康。

Subjects with isolated GH deficiency due to a null GHRHR mutation eat proportionally more, but healthier than controls.

作者信息

Oliveira-Santos Alécia A, Salvatori Roberto, Gomes-Santos Elenilde, Santana João A M, Leal Ângela C G B, Barbosa Rita A A, Oliveira Carla R P, Souza Anita H O, Valença Eugênia H O, Aguiar-Oliveira Manuel H

机构信息

Division of Endocrinology, Federal University of Sergipe, Aracaju, SE, 49060-100, Brazil.

Division of Endocrinology, Diabetes and Metabolism, Johns Hopkins University School of Medicine, 1830 East Monument Street Suite #333, Baltimore, MD, 21287, USA.

出版信息

Endocrine. 2016 Feb;51(2):317-22. doi: 10.1007/s12020-015-0670-2. Epub 2015 Jun 23.

Abstract

The GH/IGF-I axis has important interactions with the alimentary system and with the balance between energy intake (EI) and energy requirement (ER). Reduced EI has been described in adult-onset acquired GH deficiency (GHD). Individuals from the Brazilian Itabaianinha cohort, with isolated GHD (IGHD) due to a homozygous mutation (c.57+1G→A) in the GHRH receptor gene, are an ideal model to study the consequences of lifetime GHD. The purpose of this study is to evaluate EI and ER in this untreated IGHD cohort. Cross-sectional study of 24 adult IGHD patients and 23 controls from the same region, matched for age and gender. Estimated EI (EEI) was evaluated by dietary recall, and estimated ER (EER) by the equation of the Dietary Reference Intakes. Fat mass was assessed by DXA. Both EEI and EER were lower in IGHD than controls. However, when corrected by body weight, EEI was higher in IGHD (p = 0.005). IGHD individuals consume in percentage more proteins (p < 0.0001), less carbohydrates (p = 0.013), and equal amount of lipids in comparison to controls. The higher EEI per body weight suggests a possible increase of orexigenic mechanisms in untreated IGHD individuals, ensuring greater caloric intake, which would have adaptive advantages for small-sized individuals in environments with limited access to food. IGHD individuals seem to have a healthier dietary pattern than CO.

摘要

生长激素/胰岛素样生长因子-I轴与消化系统以及能量摄入(EI)和能量需求(ER)之间的平衡有着重要的相互作用。在成人起病的获得性生长激素缺乏症(GHD)中,已发现能量摄入减少。来自巴西伊塔巴亚宁哈队列的个体,由于生长激素释放激素(GHRH)受体基因的纯合突变(c.57+1G→A)而患有孤立性生长激素缺乏症(IGHD),是研究终身生长激素缺乏后果的理想模型。本研究的目的是评估这个未经治疗的IGHD队列中的能量摄入和能量需求。对来自同一地区的24名成年IGHD患者和23名对照进行横断面研究,根据年龄和性别进行匹配。通过饮食回忆评估估计能量摄入(EEI),通过膳食参考摄入量方程评估估计能量需求(EER)。通过双能X线吸收法(DXA)评估脂肪量。IGHD患者的EEI和EER均低于对照组。然而,校正体重后,IGHD患者的EEI更高(p = 0.005)。与对照组相比,IGHD个体摄入的蛋白质百分比更高(p < 0.0001),碳水化合物更少(p = 0.013),脂质摄入量相当。每体重较高的EEI表明未经治疗的IGHD个体中可能存在促食欲机制增加,确保更高的热量摄入,这对于在食物获取有限的环境中体型较小的个体具有适应性优势。IGHD个体的饮食模式似乎比对照组更健康。

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