Division of Endocrinology, Federal University of Sergipe, Aracaju, Sergipe, 49060-100, Brazil.
Division of Endocrinology, Diabetes and Metabolism, The Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
Endocrine. 2019 Sep;65(3):710-713. doi: 10.1007/s12020-019-01998-7. Epub 2019 Jul 10.
A reciprocal relationship exists between the skin and the GH/IGF-I axis. Skin produces both IGF- I and vitamin D, and GH and IGF-I exert several actions in the skin. Reduced sweating and altered phosphor-calcium homeostasis are occasionally reported in subjects with GH deficiency (GHD), mostly in the setting of hypopituitarism, therefore associated to other hormonal deficiencies. It is unclear whether these findings are due to GHD. The aim of this study was to assess skin function in subjects with isolated GHD (IGHD) due to a mutation in the GHRH receptor gene.
In a cross-sectional study we enrolled 20 IGHD and 20 local controls. Sweating (volume, conductivity and chloride content) was assessed by a 30 min pilocarpine iontophoresis test, using the Macroduct® Sweat Collection System. IGF-I, Insulin, PTH, 25-hydroxyvitamin D, C-reactive protein (CRP), CPK, glucose, calcium, phosphate, alkaline phosphatase, total proteins and fractions, urinary calcium, and insulin were measured. HOMA-IR was calculated.
IGHD presented lower sweating, but normal vitamin D and phosphor-calcium homeostasis. Additionally, IGHD subjects presented lower HOMA-IR, higher CRP and reduced CPK.
Untreated IGHD cause reduction in sweating, but does not affect phosphor-calcium homeostasis.
皮肤和 GH/IGF-I 轴之间存在着相互关系。皮肤既能产生 IGF-I，也能产生维生素 D，而 GH 和 IGF-I 对皮肤有多种作用。GH 缺乏症（GHD）患者，尤其是伴有垂体功能减退症的患者，偶尔会出现出汗减少和磷钙稳态改变，因此与其他激素缺乏有关。目前尚不清楚这些发现是否是由 GHD 引起的。本研究的目的是评估由于 GH 释放激素受体基因突变导致的孤立性 GHD（IGHD）患者的皮肤功能。
我们进行了一项横断面研究，共纳入了 20 名 IGHD 患者和 20 名本地对照者。通过使用 Macroduct® Sweat Collection System 进行 30 分钟的毛果芸香碱离子电渗疗法，评估出汗量（体积、电导率和氯含量）。测量 IGF-I、胰岛素、甲状旁腺激素、25-羟维生素 D、C 反应蛋白（CRP）、肌酸磷酸激酶（CPK）、血糖、钙、磷、碱性磷酸酶、总蛋白及其各分数、尿钙和胰岛素。计算 HOMA-IR。
IGHD 患者的出汗量较低，但维生素 D 和磷钙稳态正常。此外，IGHD 患者的 HOMA-IR 较低，CRP 较高，CPK 降低。
未经治疗的 IGHD 可导致出汗减少，但不会影响磷钙稳态。
