de Herder W W, Uitterlinden P, van der Lely A J, Hofland L J, Lamberts S W
Department of Internal Medicine III, Erasmus University, Rotterdam, The Netherlands.
Eur J Endocrinol. 1995 Aug;133(2):195-9. doi: 10.1530/eje.0.1330195.
Twenty-three patients with active acromegaly underwent serum sampling for growth hormone (GH), insulin and insulin-like growth factor binding protein 1 (IGFBP-1) after placebo or single doses of octreotide or bromocriptine. Integrated 24-h serum GH levels decreased by 90% after octreotide and 49% after bromocriptine. A statistically significant correlation between the course of GH levels after octreotide and bromocriptine was observed (p < 0.001). Octreotide, but not bromocriptine, induced a significant increase in integrated 24-h serum IGFBP-1 levels to 37.4 times the baseline values. Bromocriptine caused a non-significant increase in integrated 24-h serum IGFBP-1 levels, which argues against a direct regulatory effect of GH on IGFBP-1 production in acromegaly. In conclusion, octreotide induces in acromegaly the production of IGFBP-1, which occurs independently of the number of somatostatin receptors on the GH-secreting pituitary adenoma. The supposed inhibitory effect of IGFBP-1 on the biological effect of IGF-1 might result in an additional clinical benefit in acromegalic patients as compared to treatment directed at the pituitary level.
23例活动期肢端肥大症患者在服用安慰剂或单剂量奥曲肽或溴隐亭后接受了生长激素（GH）、胰岛素及胰岛素样生长因子结合蛋白1（IGFBP-1）的血清样本采集。奥曲肽治疗后24小时血清GH水平的综合值下降了90%，溴隐亭治疗后下降了49%。观察到奥曲肽和溴隐亭治疗后GH水平变化过程之间存在统计学显著相关性（p < 0.001）。奥曲肽可使24小时血清IGFBP-1水平的综合值显著升高至基线值的37.4倍，而溴隐亭则无此作用。溴隐亭使24小时血清IGFBP-1水平的综合值出现非显著性升高，这表明GH对肢端肥大症患者IGFBP-1的产生无直接调节作用。总之，奥曲肽可诱导肢端肥大症患者产生IGFBP-1，这一过程独立于分泌GH的垂体腺瘤上生长抑素受体的数量。与针对垂体水平的治疗相比，IGFBP-1对IGF-1生物学效应的假定抑制作用可能会给肢端肥大症患者带来额外的临床益处。
