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生长激素对合并使用生长激素释放激素和精氨酸的肥胖纤维肌痛综合征患者的反应。

GH Responsiveness to Combined GH-Releasing Hormone and Arginine Administration in Obese Patients with Fibromyalgia Syndrome.

作者信息

Rigamonti Antonello E, Grugni Graziano, Arreghini Marco, Capodaglio Paolo, De Col Alessandra, Agosti Fiorenza, Sartorio Alessandro

机构信息

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

Experimental Laboratory for Auxo-Endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Verbania, Italy.

出版信息

Int J Endocrinol. 2017;2017:3106041. doi: 10.1155/2017/3106041. Epub 2017 Jun 28.

Abstract

Reportedly, fibromyalgia (FM) is frequently associated with reduced IGF-1 levels and GH hyporesponsiveness to different GH stimulation tests. Since there is a high prevalence of obesity in FM, and obesity itself is characterized by hyposomatotropism, the aim of this study was to assess IGF-1 levels and GH responsiveness in sixteen severely obese women suffering from FM, who, subdivided into two subgroups on the basis of their age-dependent IGF-1 values (> or <-2 SDS), underwent the combined GHRH plus arginine test. Four out of 16 obese women with FM (25%) had low IGF-1 SDS values, 2 cases of this subgroup (12.5%) failing also to normally respond to the test. Among patients with normal GH responses, 4 showed a delayed GH peak. The subgroup with low IGF-1 SDS values had higher BMI than that with normal IGF-1 SDS. GH peak and area under the curve were not correlated with CRP, ESR, or tender point score, while significant correlations were found with fat-free mass and fat mass. In conclusion, this study shows the existence of a high prevalence of GH-IGF-1 dysfunction in patients with both FM and obesity, presumably as a consequence of the obese rather than fibromyalgic condition.

摘要

据报道,纤维肌痛(FM)常与胰岛素样生长因子-1(IGF-1)水平降低以及生长激素(GH)对不同GH刺激试验反应低下有关。由于FM患者中肥胖的患病率很高,且肥胖本身的特征是生长激素分泌不足,本研究的目的是评估16名患有FM的严重肥胖女性的IGF-1水平和GH反应性,这些女性根据其年龄相关的IGF-1值(>或<-2 SDS)分为两个亚组,接受了生长激素释放激素(GHRH)加精氨酸联合试验。16名患有FM的肥胖女性中有4名(25%)IGF-1 SDS值较低,该亚组中有2例(12.5%)对试验也无正常反应。在GH反应正常的患者中,4例出现GH峰值延迟。IGF-1 SDS值低的亚组的体重指数(BMI)高于IGF-1 SDS值正常的亚组。GH峰值和曲线下面积与C反应蛋白(CRP)、红细胞沉降率(ESR)或压痛点评分无相关性,而与去脂体重和脂肪量存在显著相关性。总之,本研究表明,FM和肥胖患者中存在高患病率的GH-IGF-1功能障碍,推测这是肥胖而非纤维肌痛状况导致的结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3359/5506478/581b96389cd8/IJE2017-3106041.001.jpg

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