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成年生长激素缺乏患者的心血管危险因素

Cardiovascular risk factors in adult patients with growth hormone deficiency.

作者信息

Rosén T, Edén S, Larson G, Wilhelmsen L, Bengtsson B A

机构信息

Department of Internal Medicine, University of Göteborg, Sweden.

出版信息

Acta Endocrinol (Copenh). 1993 Sep;129(3):195-200. doi: 10.1530/acta.0.1290195.

Abstract

Patients with adult onset growth hormone deficiency have a decreased life expectancy owing to an increased mortality from cardiovascular disease. In the present study, 104 subjects (66 men and 38 women, aged 22-74 years) with growth hormone deficiency and with adequate replacement therapy with glucocorticoids, thyroid hormones and gonadal steroids were studied with respect to known risk factors for cardiovascular disease. For comparison, data from a population study, "the MONICA study", were obtained. The patients had a significantly higher body mass index compared to controls (p < 0.001). Serum triglyceride concentration was higher (p < 0.001) but there was no difference in serum total cholesterol concentration. Serum high-density lipoprotein cholesterol concentration was lower (p < 0.001) in the patients. There was no difference in the prevalence of diabetes mellitus. The prevalence of treated hypertension was higher (p < 0.05) in the patients but the prevalence of smoking was lower (p < 0.001). Even after taking the increased body mass index into consideration, the changes in the prevalence of treated hypertension (p < 0.05) and in the serum concentrations of triglycerides (p < 0.05) and high-density lipoprotein concentrations (p < 0.001) remained. These results indicate that growth hormone deficiency alters lipoprotein metabolism and increases the risk for development of hypertension, which in turn might contribute to the increased risk for cardiovascular disease.

摘要

成年期生长激素缺乏症患者的预期寿命缩短,原因是心血管疾病导致的死亡率增加。在本研究中,对104名生长激素缺乏且已接受糖皮质激素、甲状腺激素和性腺类固醇充分替代治疗的受试者(66名男性和38名女性,年龄22 - 74岁)进行了心血管疾病已知危险因素方面的研究。为作比较,获取了一项人群研究“MONICA研究”的数据。与对照组相比,患者的体重指数显著更高(p < 0.001)。血清甘油三酯浓度更高(p < 0.001),但血清总胆固醇浓度无差异。患者的血清高密度脂蛋白胆固醇浓度更低(p < 0.001)。糖尿病患病率无差异。接受治疗的高血压患病率在患者中更高(p < 0.05),但吸烟患病率更低(p < 0.001)。即使考虑到体重指数增加,接受治疗的高血压患病率(p < 0.05)、血清甘油三酯浓度(p < 0.05)和高密度脂蛋白浓度(p < 0.001)的变化仍然存在。这些结果表明,生长激素缺乏会改变脂蛋白代谢并增加患高血压的风险,这反过来可能导致心血管疾病风险增加。

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