Höybye Charlotte, Faseh Laia, Himonakos Christos, Pielak Tomasz, Eugen-Olsen Jesper
Patient Area Endocrinology and Nephrology, Infection and Inflammation Theme, Karolinska University Hospital, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Endocr Connect. 2019 Jun 1;8(6):772-779. doi: 10.1530/EC-19-0159.
Growth hormone deficiency (GHD) syndrome is associated with adverse levels of several risk factors for cardiovascular diseases (CVD), including metabolic inflammation. However, the impact of GHD and GH treatment on low-grade inflammation is unknown. The aim of the study was to establish the level of the low-grade inflammation biomarker soluble urokinase plasminogen activator receptor (suPAR) in adults with GHD and the response to long-term GH treatment. Measurements of suPAR and CRP were performed in bio-bank serum samples from 72 adults, 34 males and 38 females, with GHD before and during at least 5 years of GH treatment. Mean age was 52.5 ± 15.5 years, BMI 27.3 ± 5 kg/m2. Clinical evaluations and blood sampling were performed at routine visits. Data on demography, anthropometry, lab results and clinical events were retrieved from post-marketing surveillance study databases and medical records. suPAR and high-sensitive (hs) CRP were analysed using ELISA and immunochemistry, respectively. At baseline blood pressure, lipid profile and fasting glucose were within the normal reference range. Baseline geometric mean and 95% CI of suPAR was 2.9 (2.7-3.3) ng/mL and of CRP 2.3 (0.6-4.0) mg/L. Mean follow-up was 8 ± 2 years. The suPAR levels remained stable during follow-up, although individual increases were seen on occurrence or presence of co-morbidities. In contrast, levels of CRP decreased. In conclusion, the decrease in CRP and indirectly the absence of an expected increase in suPAR over time indicates a favourable effect of GH on low-grade inflammation.
生长激素缺乏（GHD）综合征与心血管疾病（CVD）的多种危险因素的不良水平相关，包括代谢性炎症。然而，GHD和生长激素（GH）治疗对低度炎症的影响尚不清楚。本研究的目的是确定成年GHD患者中低度炎症生物标志物可溶性尿激酶型纤溶酶原激活物受体（suPAR）的水平以及对长期GH治疗的反应。在72名成年患者（34名男性和38名女性）的生物样本库血清样本中，在至少5年的GH治疗前和治疗期间测量了suPAR和C反应蛋白（CRP）。平均年龄为52.5±15.5岁，体重指数（BMI）为27.3±5kg/m²。在常规就诊时进行临床评估和血液采样。从上市后监测研究数据库和病历中检索人口统计学、人体测量学、实验室结果和临床事件的数据。分别使用酶联免疫吸附测定（ELISA）和免疫化学分析法分析suPAR和高敏（hs）CRP。基线时血压、血脂谱和空腹血糖均在正常参考范围内。suPAR的基线几何平均值和95%置信区间为2.9（2.7 - 3.3）ng/mL，CRP为2.3（0.6 - 4.0）mg/L。平均随访时间为8±2年。随访期间suPAR水平保持稳定，尽管在合并症发生或存在时个别患者有所升高。相比之下，CRP水平下降。总之，CRP的下降以及间接观察到的suPAR未随时间出现预期升高表明GH对低度炎症具有有利影响。
