Chong P K, Jung R T, Scrimgeour C M, Rennie M J, Paterson C R
Department of Medicine, Ninewells Hospital and Medical School, Dundee, UK.
Clin Endocrinol (Oxf). 1994 Jan;40(1):103-10. doi: 10.1111/j.1365-2265.1994.tb02451.x.
We assessed whether the obesity observed in growth hormone deficient adults is maintained by a reduction in energy expenditure. We studied the effects of exogenous growth hormone on energy expenditure and body composition.
We performed an open study with growth hormone administered at 0.5 units per kilogram ideal body weight per week for 3 months.
Seven growth hormone deficient adults were studied. Thirty-eight healthy volunteers had their resting metabolic rate measured, with seven of them proceeding to have their total energy expenditure assessed.
Total energy expenditure was measured by the doubly labelled water method (D2O18), resting metabolic rate by ventilated hood indirect calorimetry, and fat free mass from the dilution volume of oxygen-18. Body composition and components of energy expenditure were assessed before, at 2 weeks and at the end of the 3-month treatment period on exogenous growth hormone.
Growth hormone deficient adults did not have a low total energy expenditure compared to healthy controls (13.12 vs 12.75 MJ/24 h) with only one patient expending less than 10 MJ/24 h. None had a resting metabolic rate lower than the 95% confidence limits of normality. The amount of energy expended on physical activity and thermogenesis was significant (6.54 MJ/24 h) and was similar to healthy controls (6.47 MJ/24 h). Resting metabolic rate increased by 15.9% after 14 days on exogenous growth hormone and was elevated 12.1% after 3 months treatment but the ratio to fat-free mass remained unaltered. Total energy expenditure increased by 13.4% after 14 days therapy. Fat-free mass increased significantly after 3 months treatment by (mean) 4.5 kg with no change in fat mass and no loss in body weight.
Obesity maintenance in growth hormone deficient adults is not a consequence of reduced total energy expenditure or a reduced exercise energy output. There was also no evidence for an energy sparing mechanism. Energy expenditure was increased by exogenous growth hormone but was not associated with a loss in fat mass or body weight suggesting the need for dietetic advice for those already obese at the outset of therapy.
我们评估了生长激素缺乏的成年人中观察到的肥胖是否由能量消耗减少所致。我们研究了外源性生长激素对能量消耗和身体成分的影响。
我们进行了一项开放研究,每周按每千克理想体重0.5单位的剂量给予生长激素,持续3个月。
对7名生长激素缺乏的成年人进行了研究。对38名健康志愿者测量了静息代谢率,其中7人继续评估其总能量消耗。
总能量消耗采用双标记水法(D2O18)测量,静息代谢率采用通风罩间接测热法测量,无脂体重通过氧-18的稀释体积测定。在使用外源性生长激素治疗前、治疗2周时和3个月疗程结束时评估身体成分和能量消耗组成部分。
与健康对照组相比,生长激素缺乏的成年人总能量消耗并不低(13.12 vs 12.75 MJ/24小时),只有1名患者的能量消耗低于10 MJ/24小时。没有人的静息代谢率低于正常范围的95%置信限。身体活动和产热所消耗的能量显著(6.54 MJ/24小时),且与健康对照组相似(6.47 MJ/24小时)。使用外源性生长激素14天后,静息代谢率增加了15.9%,治疗3个月后升高了12.1%,但与无脂体重的比值保持不变。治疗14天后,总能量消耗增加了13.4%。治疗3个月后,无脂体重显著增加(平均)4.5千克,脂肪量无变化,体重无减轻。
生长激素缺乏的成年人维持肥胖并非总能量消耗减少或运动能量输出降低的结果。也没有证据表明存在能量节约机制。外源性生长激素增加了能量消耗,但与脂肪量或体重减轻无关,这表明对于治疗开始时就已肥胖的患者需要给予饮食建议。