Sorkina E L, Chichkova V V, Sklyanik I A, Shestakova M V, Mel'nichenko G A, Barkan A
Endocrinology Research Centre.
University of Michigan, Ann Arbor.
Probl Endokrinol (Mosk). 2021 Jan 21;67(1):52-59. doi: 10.14341/probl12660.
The exact physiological basis for the suppression of growth hormone secretion by oral glucose intake remains unknown, despite the widespread use of the oral glucose tolerance test in endocrinology. Lack of growth hormone suppression by glucose occurs in about a third of patients with acromegaly, as well as in other disorders. It is currently known that the secretion of growth hormone is affected by various factors, such as age, gender, body mass index, and the redistribution of adipose tissue. There is also evidence of the impact of overeating as well as being overweight on the secretion of growth hormone. It is known that both of these conditions are associated with hyperinsulinemia, which determines the possibility of its predominant role in suppressing the secretion of growth hormone. The purpose of this review is to discuss the accumulated data on the isolated effects of hyperglycemia and hyperinsulinemia on growth hormone secretion, as well as other metabolic regulators and conditions affecting its signaling. Understanding of the pathophysiological basis of these mechanisms is essential for further research of the role of glucose and insulin in the metabolic regulation of growth hormone secretion. However, the studies in animal models are complicated by interspecific differences in the response of growth hormone to glucose loading, and the only possible available model in healthy people may be the hyperinsulinemic euglycemic clamp.
尽管口服葡萄糖耐量试验在内分泌学中被广泛应用,但口服葡萄糖抑制生长激素分泌的确切生理基础仍不清楚。约三分之一的肢端肥大症患者以及其他疾病患者存在葡萄糖对生长激素抑制作用缺乏的情况。目前已知生长激素的分泌受多种因素影响,如年龄、性别、体重指数以及脂肪组织的重新分布。也有证据表明暴饮暴食和超重对生长激素分泌有影响。众所周知,这两种情况都与高胰岛素血症有关,而高胰岛素血症决定了其在抑制生长激素分泌中可能起主要作用。本综述的目的是讨论关于高血糖和高胰岛素血症对生长激素分泌的单独影响,以及其他影响其信号传导的代谢调节因子和状况的累积数据。了解这些机制的病理生理基础对于进一步研究葡萄糖和胰岛素在生长激素分泌代谢调节中的作用至关重要。然而,动物模型研究因生长激素对葡萄糖负荷反应的种间差异而变得复杂,健康人唯一可行的可用模型可能是高胰岛素正常血糖钳夹技术。