Weaver J U, Monson J P, Noonan K, John W G, Edwards A, Evans K A, Cunningham J
Department of Endocrinology, Royal London Hospital and Medical College, United Kingdom.
J Clin Endocrinol Metab. 1995 Jan;80(1):153-9. doi: 10.1210/jcem.80.1.7829604.
GH deficiency is associated with increased cardiovascular morbidity, which may be determined by alterations in vascular risk factors. We report the effect of partially treated hypopituitarism and subsequent GH replacement (mean dose, 0.2 IU/kg.week) on putative cardiovascular risk factors in 22 nondiabetic hypopituitary subjects in a 6-month, double blind, controlled study (active/placebo ratio, 11:11). All patients were subsequently treated with GH for a further 6 months. Total fat, percent body fat, and central fat were measured by dual energy x-ray absorptiometry. The hypopituitary patients had increased percent fat (P = 0.03) and central fat (P < 0.01) compared with body mass index-matched controls. Before GH treatment, fasting (total) and specific insulin positively correlated with body mass index (P = 0.02 and P < 0.001, respectively), waist/hip ratio (P = 0.05 and P = 0.01), and central fat (P = 0.03 and P = 0.003). Specific insulin and insulin sensitivity (IS), calculated by homeostatic model of assessment, were related to total fat (P < 0.001 and P = 0.02). GH treatment for 6 months led to a reduction in total fat (P < 0.02), percent fat (P = 0.002), central fat (P = 0.012), waist/hip ratio (P < 0.05), total cholesterol (P = 0.03), and apolipoprotein-B (P = 00001), as well as a decrease in the IS from 36.9% (range, 12-100%) to 25% (range, 2.5-55%; P = 0.0002). This was paralleled by a rise in fasting (total) and specific insulin (P = 0.016 and P = 0.002). The degree of correlation among indices of IS, body composition, and fat distribution increased after GH treatment. Fasting plasma glucose rose significantly, but was within the reference range. During 12 months of GH therapy, a significant increase in serum lipoprotein-(a) was observed (P < 0.05). Although GH has beneficial effects on central adiposity and lipid fractions, it is also associated with a decrease in IS; these effects may vary between individuals.
生长激素缺乏与心血管疾病发病率增加有关，这可能由血管危险因素的改变所决定。在一项为期6个月的双盲对照研究（活性药物/安慰剂比例为11:11）中，我们报告了部分治疗的垂体功能减退症及随后的生长激素替代治疗（平均剂量，0.2 IU/kg·周）对22例非糖尿病垂体功能减退患者假定心血管危险因素的影响。所有患者随后又接受了6个月的生长激素治疗。通过双能X线吸收法测量总脂肪量、体脂百分比和中心脂肪量。与体重指数匹配的对照组相比，垂体功能减退患者的体脂百分比（P = 0.03）和中心脂肪量（P < 0.01）增加。在生长激素治疗前，空腹（总）胰岛素和特异性胰岛素与体重指数呈正相关（分别为P = 0.02和P < 0.001）、腰臀比（P = 0.05和P = 0.01）以及中心脂肪量（P = 0.03和P = 0.003）。通过稳态模型评估计算得出的特异性胰岛素和胰岛素敏感性（IS）与总脂肪量相关（P < 0.001和P = 0.02）。生长激素治疗6个月导致总脂肪量减少（P < 0.02）、体脂百分比（P = 0.002）、中心脂肪量（P = 0.012）、腰臀比（P < 0.05）、总胆固醇（P = 0.03）和载脂蛋白B（P = 0.0001）降低，同时IS从36.9%（范围为12 - 100%）降至25%（范围为2.5 - 55%；P = 0.0002）。与此同时，空腹（总）胰岛素和特异性胰岛素升高（P = 0.016和P = 0.002）。生长激素治疗后，IS、身体成分和脂肪分布指标之间的相关性程度增加。空腹血糖显著升高，但仍在参考范围内。在12个月的生长激素治疗期间，观察到血清脂蛋白(a)显著增加（P < 0.05）。虽然生长激素对中心性肥胖和脂质成分有有益作用，但它也与IS降低有关；这些影响在个体之间可能有所不同。
