Department of Pediatrics, Technical University München, D-80804 Munich, Germany.
Department of Pediatrics, Klinikum Wels-Grieskirchen, Grieskirchner Str. 42, A-4600 Wels, Austria.
Int J Mol Sci. 2019 Feb 12;20(3):772. doi: 10.3390/ijms20030772.
In the state of insulin deficiency, the growth hormone-insulin-like growth factor-I (GH⁻IGF-I) axis is altered due to hepatic GH resistance, which leads to GH hypersecretion and low circulating IGF-I concentration. On the other hand, both growth hormone deficiency (GHD) and GH excess have significant influence on carbohydrate metabolism. These complex interactions are challenging in diagnosing GHD in subjects with type 1 diabetes mellitus (T1DM) and in treating subjects with T1DM with GH. So far, there is only limited clinical experience in GH treatment in patients with T1DM, but recently first reports on metabolic safety and efficacy of GH treatment in subjects with T1DM have been published.
在胰岛素缺乏的情况下,由于肝脏对生长激素的抵抗,生长激素-胰岛素样生长因子-1(GH-IGF-1)轴发生改变,导致 GH 分泌过多和循环 IGF-1 浓度降低。另一方面,生长激素缺乏症(GHD)和 GH 过多都会对碳水化合物代谢产生重大影响。这些复杂的相互作用在诊断 1 型糖尿病(T1DM)患者的 GHD 和用 GH 治疗 T1DM 患者方面具有挑战性。到目前为止,在 T1DM 患者中进行 GH 治疗的临床经验有限,但最近已发表了关于 T1DM 患者 GH 治疗的代谢安全性和疗效的首批报告。