Snyder D K, Clemmons D R, Underwood L E
Department of Medicine, University of North Carolina, Chapel Hill 27599.
J Clin Endocrinol Metab. 1988 Jul;67(1):54-61. doi: 10.1210/jcem-67-1-54.
We found in a previous study that injections of GH for 3 weeks caused nitrogen conservation despite restriction of intake to 24 Cal (100 kJ)/kg ideal BW (IBW). To determine the effects of longer periods of treatment and further caloric restriction on nitrogen balance, lipolysis, and body composition, 20 obese (30-67% over IBW) subjects (16 women and 4 men; 20-54 yr old) were fed a diet of 18 Cal (75 kJ)/kg IBW with 1.2 g protein/kg IBW daily for 13 weeks. During weeks 2-12, 10 subjects received injections of recombinant methionyl GH (0.1 mg/kg IBW every other day), and the other 10 sex-, age-, and weight-matched subjects were given injections of saline. There were no significant differences between the two groups in total weight loss [GH, 13.9 +/- 3.0 (+/- SD) kg; saline, 15.2 +/- 3.8 kg ) or the percentage of body fat lost (GH, 8.1 +/- 2.4%; saline, 7.5 +/- 1.5%), although GH injection caused a significant acute increment in serum FFA concentrations (GH, 0.53 +/- 0.37 mmol/L; saline, 0.08 +/- 0.22 mmol/L; P less than 0.001) throughout the study. This acute lipolytic response to GH decreased significantly, from 0.86 +/- 0.32 mmol/L on day 1 of GH treatment to 0.35 +/- 0.41 mmol/L by day 35 of GH injection (P less than 0.01). Nitrogen balance was significantly more positive in the group receiving GH during the first 33 days of the GH injection period [GH, +0.07 +/- 1.82 g/day (+5.0 +/- 130.0 mmol/day); saline, -1.91 +/- 1.10 g/day (-136.3 +/- 78.5 mmol/day); P less than 0.001]. During the last 44 days of GH injection, however, the nitrogen balance in the two groups was similar [GH, -0.90 +/- 1.65 g/day (-64.2 +/- 117.8 mmol/day); saline, -1.08 +/- 0.95 g/day (-77.1 +/- 67.8 mmol/day); P = NS]. Mean plasma insulin-like growth factor I (IGF-I) concentrations rose from a basal value of 1.6 +/- 0.8 to 2.9 +/- 1.2 U/mL by 48 h after the first GH injection and ranged subsequently from 3.2 +/- 1.3 to 4.9 +/- 3.3 U/mL during GH injection (P less than 0.001). In contrast, the mean IGF-I concentration did not change in the group that received saline. Dietary restriction during the first week of study caused serum T3 concentrations to decline in both groups.(ABSTRACT TRUNCATED AT 400 WORDS)
我们在之前的一项研究中发现,尽管将摄入量限制在24千卡(100千焦)/千克理想体重(IBW),注射生长激素(GH)3周仍可导致氮潴留。为了确定更长治疗期以及进一步热量限制对氮平衡、脂肪分解和身体成分的影响,20名肥胖受试者(超过IBW的30%-67%)(16名女性和4名男性;年龄20-54岁)每天按18千卡(75千焦)/千克IBW和1.2克蛋白质/千克IBW的标准进食,持续13周。在第2至12周期间,10名受试者每隔一天注射重组甲硫氨酰生长激素(0.1毫克/千克IBW),另外10名年龄、性别和体重匹配的受试者注射生理盐水。两组在总体重减轻方面无显著差异[生长激素组,13.9±3.0(±标准差)千克;生理盐水组,15.2±3.8千克],或在体脂减少百分比方面也无显著差异[生长激素组,8.1±2.4%;生理盐水组,7.5±1.5%],尽管在整个研究过程中,注射生长激素导致血清游离脂肪酸(FFA)浓度显著急性升高[生长激素组,0.53±0.37毫摩尔/升;生理盐水组,0.08±0.22毫摩尔/升;P<0.001]。这种对生长激素的急性脂肪分解反应显著降低,从生长激素治疗第1天的0.86±0.32毫摩尔/升降至生长激素注射第35天的0.35±0.41毫摩尔/升(P<0.01)。在生长激素注射期的前33天,接受生长激素治疗的组氮平衡明显更正向[生长激素组,+0.07±1.82克/天(+5.0±130.0毫摩尔/天);生理盐水组,-1.91±1.10克/天(-136.3±78.5毫摩尔/天);P<0.001]。然而,在生长激素注射的最后44天,两组的氮平衡相似[生长激素组,-0.90±1.65克/天(-64.2±117.8毫摩尔/天);生理盐水组,-1.08±0.95克/天(-77.1±67.8毫摩尔/天);P=无显著差异]。首次注射生长激素后48小时内,血浆胰岛素样生长因子I(IGF-I)平均浓度从基础值1.6±0.8升至2.9±1.2 U/mL,随后在生长激素注射期间范围为3.2±1.3至4.9±3.3 U/mL(P<0.001)。相比之下,接受生理盐水注射的组中IGF-I平均浓度未发生变化。研究第一周的饮食限制导致两组血清三碘甲状腺原氨酸(T3)浓度下降。(摘要截选至400字)