Sartorio A, Conti A, Monzani M, Morabito F
Laboratorio Sperimentale di Ricerche Endocrinologiche, Centro Auxologico Italiano, IRCCS, Milano.
Minerva Endocrinol. 1994 Mar;19(1):13-8.
In adults with childhood onset GH deficiency, serum total and LDL cholesterol levels were significantly higher (p < 0.05 and < 0.01, respectively), while serum HDL cholesterol levels were significantly lower (p < 0.05) than those recorded in an age and sex matched control group. These biochemical alterations determined the presence of a marked increase of coronary risk indexes (total/HDL cholesterol and LDL/HDL cholesterol) which were significantly higher (p < 0.0001) than in controls. Serum VLDL and triglycerides levels were similar to those found in controls. After recombinant GH treatment (0.5 IU/kg/week, sc), serum total and LDL cholesterol levels were significantly reduced, becoming similar to those recorded in controls after six months' therapy. Serum HDL cholesterol levels, which were slightly reduced after 3 months, significantly increased after 6 months of GH treatment, becoming similar to those recorded in controls; no significant modifications were observed in VLDL cholesterol and triglycerides levels during treatment. The coronary risk indexes fell during GH treatment, but still remained higher than in controls. On the basis of these promising data, it is tempting to speculate that more prolonged GH treatment might be able to ameliorate the risk for cardiovascular diseases in adults with GH deficiency. Although further additional studies with a larger number of patients are needed to confirm these preliminary observations, adults with GH deficiency should be recommended to take into great consideration the control of other risk factors involved in the genesis of coronary disease.
在儿童期发病的生长激素缺乏症成年患者中,血清总胆固醇和低密度脂蛋白胆固醇水平显著升高(分别为p < 0.05和< 0.01),而血清高密度脂蛋白胆固醇水平显著降低(p < 0.05),与年龄和性别匹配的对照组相比。这些生化改变导致冠状动脉风险指数(总胆固醇/高密度脂蛋白胆固醇和低密度脂蛋白胆固醇/高密度脂蛋白胆固醇)显著升高(p < 0.0001),高于对照组。血清极低密度脂蛋白和甘油三酯水平与对照组相似。重组生长激素治疗(0.5 IU/kg/周,皮下注射)后,血清总胆固醇和低密度脂蛋白胆固醇水平显著降低,治疗6个月后与对照组记录水平相似。生长激素治疗3个月后略有降低的血清高密度脂蛋白胆固醇水平,在治疗6个月后显著升高,与对照组记录水平相似;治疗期间极低密度脂蛋白胆固醇和甘油三酯水平未观察到显著变化。生长激素治疗期间冠状动脉风险指数下降,但仍高于对照组。基于这些有前景的数据,很容易推测更长时间的生长激素治疗可能能够改善生长激素缺乏症成年患者的心血管疾病风险。尽管需要更多患者的进一步研究来证实这些初步观察结果,但应建议生长激素缺乏症成年患者高度重视控制冠心病发生中涉及的其他风险因素。