Kopelman P G, Noonan K, Goulton R, Forrest A J
Clin Endocrinol (Oxf). 1985 Jul;23(1):87-94. doi: 10.1111/j.1365-2265.1985.tb00187.x.
We have previously reported an impaired growth hormone (GH) response and abnormal prolactin release to insulin-hypoglycaemia in obesity. We suggested that obese women with an absent prolactin response to hypoglycaemia ('non-responders') have a disorder of hypothalamic function. We have now investigated the GH response to i.v. growth hormone releasing factor, GHRF (1-29)NH2, in 14 obese women and nine age-matched normal-weight women. We found a significantly reduced GH response to GHRF in the obese women as compared with controls (mean peak +/- SEM: obese 8.9 +/- 2 mu/l, controls 28 +/- 2 mu/l; P less than 0.01). When the obese women were divided on the basis of their prolactin response to insulin-hypoglycaemia (seven 'non-responders', mean weight 102 +/- 5 kg; seven responders, mean weight 108 +/- 8 kg) a similar GH response to GHRF was found between the two groups but the GH response to hypoglycaemia was significantly less in the 'non-responder' women (mean peak 'non-responders' 10.5 +/- 3 mu/l, responders 27 +/- 4 mu/l; P less than 0.05). We conclude that obesity may be characterized by an impaired GH response to both i.v. GHRF and insulin-hypoglycaemia, which suggests altered hypothalamic-pituitary function. The finding that the GH response to hypoglycaemia is significantly less in the obese prolactin 'non-responder' women supports the hypothesis for a hypothalamic disorder.
我们之前曾报道过，肥胖人群中生长激素（GH）对胰岛素低血糖的反应受损，且催乳素释放异常。我们认为，对低血糖无催乳素反应的肥胖女性（“无反应者”）存在下丘脑功能紊乱。我们现在研究了14名肥胖女性和9名年龄匹配的正常体重女性对静脉注射生长激素释放因子GHRF（1-29）NH2的GH反应。我们发现，与对照组相比，肥胖女性对GHRF的GH反应显著降低（平均峰值±标准误：肥胖组8.9±2 μ/l，对照组28±2 μ/l；P<0.01）。根据肥胖女性对胰岛素低血糖的催乳素反应进行分组（7名“无反应者”，平均体重102±5 kg；7名反应者，平均体重108±8 kg），两组对GHRF的GH反应相似，但“无反应者”女性对低血糖的GH反应显著更低（“无反应者”平均峰值10.5±3 μ/l，反应者27±4 μ/l；P<0.05）。我们得出结论，肥胖的特征可能是对静脉注射GHRF和胰岛素低血糖的GH反应受损，这表明下丘脑-垂体功能发生了改变。肥胖催乳素“无反应者”女性对低血糖的GH反应显著更低这一发现支持了下丘脑紊乱的假说。
