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对生长激素缺乏的成年人进行为期两周的重组人生长激素(GH)每日注射及持续输注。II. 对血清脂蛋白、脂蛋白及肝脂酶活性的影响。

Two weeks of daily injections and continuous infusion of recombinant human growth hormone (GH) in GH-deficient adults. II. Effects on serum lipoproteins and lipoprotein and hepatic lipase activity.

作者信息

Oscarsson J, Ottosson M, Johansson J O, Wiklund O, Mårin P, Björntorp P, Bengtsson B A

机构信息

Research Centre for Endocrinology and Metabolism, Göteborg University,Sahlgrenska Hospital, Sweden.

出版信息

Metabolism. 1996 Mar;45(3):370-7. doi: 10.1016/s0026-0495(96)90293-0.

Abstract

Recombinant human growth hormone (GH) administered as daily subcutaneous (SC) injections has been shown to affect serum lipoproteins in GH-deficient subjects. However, the effects of continuous infusion of GH on serum lipoproteins have not been investigated in GH-deficient adults. The aim of the present study was to compare effects of daily injections and continuous infusion of GH on lipoprotein metabolism. Recombinant human GH (0.25 U/kg/wk) was administered to nine GH-deficient adult men during a period of 14 days in two different ways, ie, as a daily SC injection at 8:00 PM and as a continuous SC infusion, with 1 month of washout between the treatments. Blood samples and tests were performed in the morning after an overnight fast before the start of GH treatment (day 0) and on day 2 and day 14 of treatment. Abdominal SC adipose tissue lipoprotein lipase (LPL), postheparin plasma LPL, and hepatic lipase (HL) activity were measured 120 minutes after the intake of 100 g glucose. Adipose tissue LPL activity decreased and postheparin plasma HL activity increased after 14 days of GH treatment irrespective of the mode of GH administration, whereas GH treatment had no effect on postheparin plasma LPL activity. Serum triglyceride and very-low-density lipoprotein (VLDL) triglyceride concentrations increased during GH treatment. However, VLDL triglyceride concentrations increased to a greater degree during treatment with daily GH injections than during continuous infusion of GH. Serum apolipoprotein (apo) B and low-density lipoprotein (LDL) cholesterol concentrations decreased during treatment with daily GH injections, but were not significantly affected by continuous GH infusion. Thus, apo B and LDL cholesterol concentrations were lower after daily GH injections versus continuous GH infusion. Serum lipoprotein(a) [Lp(a)] and apo E concentrations increased during both modes of GH treatment. However, continuous infusion of GH resulted in a more marked increase in Lp(a) and apo E concentrations than daily GH injections. Minor effects were observed on serum apo A-I concentrations but high-density lipoprotein (HDL) cholesterol concentrations were not affected. In conclusion, GH treatment of GH-deficient men influenced adipose tissue LPL and postheparin plasma HL activity, as well as serum lipoprotein concentrations. Moreover, continuous GH infusion and daily GH injections differed with respect to the magnitude of effects on several lipoprotein fractions including VLDL triglycerides, LDL cholesterol, apo B, apo E, and Lp(a) concentrations.

摘要

已证明,每日皮下注射重组人生长激素(GH)会影响生长激素缺乏症患者的血清脂蛋白。然而,生长激素持续输注对生长激素缺乏的成年人血清脂蛋白的影响尚未得到研究。本研究的目的是比较每日注射和持续输注生长激素对脂蛋白代谢的影响。在14天内,以两种不同方式向9名生长激素缺乏的成年男性施用重组人生长激素(0.25U/kg/周),即晚上8点每日皮下注射和持续皮下输注,两种治疗之间有1个月的洗脱期。在生长激素治疗开始前(第0天)以及治疗的第2天和第14天,隔夜禁食后的早晨采集血样并进行检测。在摄入100g葡萄糖120分钟后,测量腹部皮下脂肪组织脂蛋白脂肪酶(LPL)、肝素后血浆LPL和肝脂肪酶(HL)活性。无论生长激素的给药方式如何,生长激素治疗14天后,脂肪组织LPL活性降低,肝素后血浆HL活性增加,而生长激素治疗对肝素后血浆LPL活性无影响。生长激素治疗期间,血清甘油三酯和极低密度脂蛋白(VLDL)甘油三酯浓度升高。然而,每日注射生长激素治疗期间,VLDL甘油三酯浓度升高的程度大于持续输注生长激素期间。每日注射生长激素治疗期间,血清载脂蛋白(apo)B和低密度脂蛋白(LDL)胆固醇浓度降低,但持续输注生长激素对其无显著影响。因此,与持续输注生长激素相比,每日注射生长激素后apo B和LDL胆固醇浓度更低。两种生长激素治疗方式下,血清脂蛋白(a)[Lp(a)]和apo E浓度均升高。然而,与每日注射生长激素相比,持续输注生长激素导致Lp(a)和apo E浓度升高更为明显。观察到对血清apo A-I浓度有轻微影响,但高密度脂蛋白(HDL)胆固醇浓度未受影响。总之,生长激素缺乏男性接受生长激素治疗会影响脂肪组织LPL和肝素后血浆HL活性以及血清脂蛋白浓度。此外,持续输注生长激素和每日注射生长激素对包括VLDL甘油三酯、LDL胆固醇、apo B、apo E和Lp(a)浓度在内的几种脂蛋白组分的影响程度不同。

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