Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki, Chuo, Kobe, 650-0017, Japan.
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Hospital, Kobe, Japan.
Pituitary. 2024 Oct;27(5):605-613. doi: 10.1007/s11102-024-01459-z. Epub 2024 Sep 19.
To elucidate the long-term efficacy and safety of growth hormone replacement therapy (GHRT) in Japanese patients with adult growth hormone deficiency (AGHD).
We conducted a retrospective study. A total of 110 patients with AGHD receiving GHRT were enrolled. Clinical and laboratory data were collected annually from the beginning of the study. Statistical analysis was performed using a linear mixed-effects model.
Of all patients, 46.4% were males, 70.9% had adult-onset GHD, and follow-up was up to 196 months, with a median of 68 months. The insulin-like growth factor-1 standard deviation score increased after the start of GHRT and remained constant for more than 11 years. Seventeen patients were followed up for more than 11 years. The body mass index increased. Waist circumference decreased in the short term but increased in the long term. The diastolic blood pressure decreased 1-5 years after the start of GHRT, and the systolic blood pressure increased 11 years after GHRT. Moreover, a long-term decrease in low-density lipoprotein cholesterol, an increase in high-density lipoprotein cholesterol, and a decrease in aspartate aminotransferase and alanine aminotransferase levels were observed. The glycosylated hemoglobin level increased after 3 years. The bone mineral density in the lumbar spine and total hip increased significantly 3 years after the start of GHRT. Finally, the number of adverse events was eight.
We demonstrated the metabolic effectiveness and safety of GHRT in Japanese patients with AGHD over a long follow-up period of 16 years.
阐明生长激素替代疗法（GHRT）在日本成人生长激素缺乏症（AGHD）患者中的长期疗效和安全性。
我们进行了一项回顾性研究。共纳入 110 例接受 GHRT 的 AGHD 患者。从研究开始时每年收集临床和实验室数据。使用线性混合效应模型进行统计分析。
所有患者中，46.4%为男性，70.9%为成年发病的 GHD，随访时间长达 196 个月，中位数为 68 个月。胰岛素样生长因子-1 标准差评分在 GHRT 开始后增加，并在 11 年以上保持稳定。17 例患者随访超过 11 年。体重指数增加。腰围在短期内下降，但长期内增加。GHRT 开始后 1-5 年内舒张压下降，GHRT 后 11 年内收缩压升高。此外，还观察到 LDL 胆固醇长期下降、HDL 胆固醇增加、天门冬氨酸氨基转移酶和丙氨酸氨基转移酶水平下降。糖化血红蛋白水平在 3 年后升高。GHRT 开始后 3 年，腰椎和全髋的骨密度显著增加。最后，不良事件的数量为 8 例。
我们在长达 16 年的随访中证明了 GHRT 在日本 AGHD 患者中的代谢疗效和安全性。
