Heinla Keiu, Vasar Eero, Reppo Ingrid, Sedman Tuuli, Volke Vallo
Department of Physiology, Institute of Biomedicine and Translational Medicine, Centre of Excellence in Genomics and Translational Medicine, University of Tartu, Ravila 19, 50110, Tartu, Estonia.
Endocrinology Unit, Tartu University Hospital, Tartu, Estonia.
Diabetes Ther. 2023 Apr;14(4):777-786. doi: 10.1007/s13300-023-01381-w. Epub 2023 Feb 17.
Growth hormone (GH) is an essential regulator of growth, body composition and fuel metabolism and, consequently, GH secretion is under the feedback control of numerous nutritional and endocrine mediators. Glucagon-like peptide 1 receptor agonists (GLP-1RAs) have been shown to exert pleiotropic effects, including stimulation of the activity of the hypothalamic-pituitary-adrenal axis. As GLP-1RAs exert multiple metabolic effects, we hypothesised that they may also affect the secretion of GH and examined the effect of a short-acting and a long-acting GLP-1 RA on GH secretion.
This is a post hoc analysis of data from clinical trials. Two separate single-group open-label clinical trials were carried out in the ambulatory care setting with a duration of 1 and 21 days, respectively. Healthy adult male and female volunteers with no chronic illnesses or use of daily medicines were recruited for the study. The two interventions were: study 1, single dose of 10 µg exenatide administered subcutaneously (s.c.); study 2, 0.6 mg liraglutide administered s.c. once daily for 21 days.
Administration of a single dose of exenatide (study 1) caused a clear increase in GH levels, peaking between 60 and 120 min post-administration. There was also a small but statistically significant decrease in luteinising hormone and testosterone levels 120 min after exenatide dosing. Administration of the long-acting GLP-1RA liraglutide daily for 21 days (study 2) elicited an increase in GH levels with no change in insulin-like growth factor-1 (IGF-1) concentrations after 3 weeks of treatment.
The results show that the administration of GLP-1RAs may elicit an increase in growth hormone levels. GLP-1 signalling may be a novel mechanism of regulation of GH secretion. This finding needs to be replicated in the placebo-controlled trial.
NCT02089256 and NCT03160261.
生长激素(GH)是生长、身体成分及能量代谢的重要调节因子,因此,GH分泌受到多种营养和内分泌介质的反馈调控。胰高血糖素样肽1受体激动剂(GLP-1RAs)已被证明具有多种效应,包括刺激下丘脑-垂体-肾上腺轴的活性。由于GLP-1RAs具有多种代谢效应,我们推测它们可能也会影响GH的分泌,并研究了一种短效和一种长效GLP-1 RA对GH分泌的影响。
这是一项对临床试验数据的事后分析。在门诊环境中分别进行了两项单组开放标签临床试验,持续时间分别为1天和21天。招募无慢性疾病且未服用日常药物的健康成年男性和女性志愿者参与研究。两项干预措施分别为:研究1,皮下注射10μg艾塞那肽单剂量;研究2,每天皮下注射0.6mg利拉鲁肽,持续21天。
单剂量注射艾塞那肽(研究1)导致GH水平明显升高,在给药后60至120分钟达到峰值。艾塞那肽给药120分钟后,促黄体生成素和睾酮水平也出现了小幅但具有统计学意义的下降。每天皮下注射长效GLP-1 RA利拉鲁肽21天(研究2),治疗3周后GH水平升高,胰岛素样生长因子-1(IGF-1)浓度无变化。
结果表明,GLP-1RAs给药可能会导致生长激素水平升高。GLP-1信号传导可能是调节GH分泌的一种新机制。这一发现需要在安慰剂对照试验中得到重复验证。
NCT02089256和NCT03160261。