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生长激素释放激素对阿尔茨海默型老年痴呆患者生长激素反应的影响

GHRH-induced GH response in patients with senile dementia of the Alzheimer type.

作者信息

Cacabelos R, Niigawa H, Ikemura Y, Yanagi Y, Tanaka S, Rodríguez-Arnao M D, Gómez-Pan A, Nishimura T

机构信息

Department of Neuropsychiatry, Osaka University Medical School, Japan.

出版信息

Acta Endocrinol (Copenh). 1988 Mar;117(3):295-301. doi: 10.1530/acta.0.1170295.

Abstract

To clarify the functional state of the somatotropinergic system at the hypothalamo-hypophyseal level in senile dementia of the Alzheimer type, the GHRH test was performed in three groups of subjects: a) healthy elderly subjects; b) early onset senile dementia patients; and c) late onset senile dementia patients. Intravenous administration of GHRH(1-44)NH2 (100 micrograms) elicited a marked plasma GH response with a maximum peak (709.54 +/- 259.0 pmol/l; P less than 0.005) 60 min after injection in patients with early onset senile dementia, but no significant response was detected in the other two groups. Electroencephalographic recording showed that GHRH modifies brain bioelectrical activity, decreasing frequency (0.52 +/- 0.15 Hz) and increasing amplitude (8.25 +/- 4.5 microV) of the electroencephalogram basic rhythm. The evaluation of mental performance and behaviour with a battery of different tests for mental assessment revealed that GHRH induces transient clinical changes in psychomotor behaviour. According to these results, it seems likely that the somatostatin deficiency reported in senile dementia of the Alzheimer type may account for the enhanced GHRH-induced GH response observed in patients with early onset senile dementia. In consequence, the GHRH test might constitute a useful antemortem marker for senile dementia of the Alzheimer type if the present results can be replicated in early stages of the disease.

摘要

为了阐明阿尔茨海默型老年性痴呆患者下丘脑 - 垂体水平生长激素能系统的功能状态,对三组受试者进行了生长激素释放激素(GHRH)试验:a)健康老年受试者;b)早发性老年性痴呆患者;c)晚发性老年性痴呆患者。静脉注射GHRH(1 - 44)NH2(100微克)后,早发性老年性痴呆患者在注射后60分钟出现明显的血浆生长激素反应,最大峰值为(709.54±259.0皮摩尔/升;P<0.005),但在其他两组中未检测到明显反应。脑电图记录显示,GHRH可改变脑生物电活动,降低脑电图基本节律的频率(0.52±0.15赫兹)并增加其振幅(8.25±4.5微伏)。通过一系列不同的心理评估测试对心理表现和行为进行评估发现,GHRH可诱导精神运动行为出现短暂的临床变化。根据这些结果,阿尔茨海默型老年性痴呆中报道的生长抑素缺乏可能是早发性老年性痴呆患者中观察到的GHRH诱导的生长激素反应增强的原因。因此,如果目前的结果能在疾病早期得到重复,GHRH试验可能成为阿尔茨海默型老年性痴呆有用的生前标志物。

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