Erdtsieck R J, Pols H A, Valk N K, van Ouwerkerk B M, Lamberts S W, Mulder P, Birkenhäger J C
Department of Internal Medicine III, University Hospital Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Clin Endocrinol (Oxf). 1995 Nov;43(5):557-65. doi: 10.1111/j.1365-2265.1995.tb02920.x.
It is known that growth hormone can induce accelerated bone turnover in GH deficient people as well as healthy elderly people. In this study we examined the effect of recombinant human GH (rhGH) on bone mineral mass and bone turnover in the presence of the bone resorption inhibiting agent, pamidronate. Effects on body composition were also studied.
Twenty-one post-menopausal osteoporotic women were treated with the bisphosphonate pamidronate during 12 months. During the initial 6 months rhGH (0.0675 IU/kg, 3 times/week) was administered in a placebo controlled fashion (10 vs 11 patients).
Bone mineral content (BMC) of the lumbar spine and femoral neck was measured with dual-energy X-ray absorptiometry and BMC of the distal and proximal forearm with single-photon absorptiometry. Body composition was measured with bioelectrical impedance and total body dual-energy X-ray absorptiometry. Serum IGF-I and biochemical indices of bone turnover were also measured.
The group treated with rhGH showed a two to three-fold increase in serum IGF-I levels. No effects on bone mineral mass were observed in the group treated with rhGH, either after the initial 6 months of treatment with rhGH or after the total period of 12 months. In women treated with pamidronate, however, a consistent increase of about 5% at the lumbar spine and somewhat less in the distal forearm was reached from 6 months onwards. In neither group was any change observed in BMC at the femoral neck or forearm. Compared to baseline, the biochemical measurements of bone turnover showed a decrease of about 50% in the pamidronate treated group, but this effect was blunted in the group additionally treated with rhGH. The body composition measurements showed clear effects of rhGH administration: a decrease in fat mass of about 5% and an increase in lean body mass of about 3%. However, these effects disappeared after the treatment with rhGH was stopped and both fat mass and lean body mass returned to initial values.
The present study suggests that treatment with rhGH blunted both the pamidronate induced accumulation of bone mineral mass and the reduction of biochemical markers of bone turnover. Furthermore, the positive effect of rhGH on body composition disappears completely after cessation of treatment with rhGH.
已知生长激素可在生长激素缺乏人群以及健康老年人中诱导骨转换加速。在本研究中，我们研究了在存在骨吸收抑制剂帕米膦酸盐的情况下，重组人生长激素（rhGH）对骨矿物质质量和骨转换的影响。还研究了其对身体成分的影响。
21名绝经后骨质疏松女性接受了12个月的双膦酸盐帕米膦酸盐治疗。在最初的6个月中，以安慰剂对照的方式给予rhGH（0.0675 IU/kg，每周3次）（10名患者与11名患者）。
用双能X线吸收法测量腰椎和股骨颈的骨矿物质含量（BMC），用单光子吸收法测量远端和近端前臂的BMC。用生物电阻抗和全身双能X线吸收法测量身体成分。还测量了血清IGF-I和骨转换的生化指标。
接受rhGH治疗的组血清IGF-I水平增加了两到三倍。在接受rhGH治疗的最初6个月后或整个12个月期间，接受rhGH治疗的组均未观察到对骨矿物质质量的影响。然而，在接受帕米膦酸盐治疗的女性中，从6个月起，腰椎的骨矿物质含量持续增加约5%，远端前臂的增加幅度略小。两组的股骨颈或前臂的BMC均未观察到任何变化。与基线相比，骨转换的生化测量显示，帕米膦酸盐治疗组下降了约50%，但在额外接受rhGH治疗的组中，这种效果减弱。身体成分测量显示了rhGH给药的明显效果：脂肪量减少约5%，瘦体重增加约3%。然而，在停止rhGH治疗后，这些效果消失，脂肪量和瘦体重均恢复到初始值。
本研究表明，rhGH治疗减弱了帕米膦酸盐诱导的骨矿物质质量积累以及骨转换生化标志物的降低。此外，rhGH治疗停止后，其对身体成分的积极作用完全消失。
