Christ Emanuel R, Egger Andrea, Allemann Sabin, Buehler Tania, Kreis Roland, Boesch Chris
Division of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland.
Department of Internal Medicine, University Hospital of Basel, CH-4056 Basel, Switzerland.
Sci Rep. 2016 Jan 21;6:19310. doi: 10.1038/srep19310.
Growth hormone replacement therapy (GHRT) increases exercise capacity and insulin resistance while it decreases fat mass in growth hormone-deficient patients (GHD). Ectopic lipids (intramyocellular (IMCL) and intrahepatocellular lipids (IHCL) are related to insulin resistance. The effect of GHRT on ectopic lipids is unknown. It is hypothesized that exercise-induced utilization of ectopic lipids is significantly decreased in GHD patients and normalized by GHRT. GHD (4 females, 6 males) and age/gender/waist-matched control subjects (CS) were studied. VO2max was assessed on a treadmill and insulin sensitivity determined by a two-step hyperinsulinaemic-euglycaemic clamp. Visceral (VAT) and subcutaneous (SAT) fat were quantified by MR-imaging. IHCL and IMCL were measured before and after a 2 h exercise at 50-60% of VO2max using MR-spectroscopy (∆IMCL, ∆IHCL). Identical investigations were performed after 6 months of GHRT. VO2max was similar in GHD and CS and significantly increased after GHRT; GHRT significantly decreased SAT and VAT. 2 h-exercise resulted in a decrease in IMCL (significant in CS and GHRT) and a significant increase in IHCL in CS and GHD pre and post GHRT. GHRT didn't significantly impact on ∆IMCL and ∆IHCL. We conclude that aerobic exercise affects ectopic lipids in patients and controls. GHRT increases exercise capacity without influencing ectopic lipids.
生长激素替代疗法（GHRT）可提高生长激素缺乏症患者（GHD）的运动能力并降低胰岛素抵抗，同时减少其脂肪量。异位脂质（肌细胞内脂质（IMCL）和肝细胞内脂质（IHCL））与胰岛素抵抗有关。GHRT对异位脂质的影响尚不清楚。据推测，GHD患者运动诱导的异位脂质利用率显著降低，而GHRT可使其恢复正常。研究了GHD患者（4名女性，6名男性）以及年龄、性别、腰围匹配的对照受试者（CS）。通过跑步机评估最大摄氧量（VO2max），并通过两步高胰岛素-正常血糖钳夹法测定胰岛素敏感性。通过磁共振成像对内脏脂肪（VAT）和皮下脂肪（SAT）进行定量分析。在以VO2max的50-60%进行2小时运动前后，使用磁共振波谱法测量IHCL和IMCL（∆IMCL，∆IHCL）。在进行6个月的GHRT治疗后进行相同的研究。GHD患者和对照受试者的VO2max相似，GHRT治疗后显著增加；GHRT显著降低了SAT和VAT。2小时运动导致IMCL减少（在对照受试者和接受GHRT治疗的患者中均显著），并且在接受GHRT治疗前后，对照受试者和GHD患者的IHCL均显著增加。GHRT对∆IMCL和∆IHCL没有显著影响。我们得出结论，有氧运动影响患者和对照受试者体内的异位脂质。GHRT可提高运动能力，但不影响异位脂质。
