Wolthers T, Lemming L, Grøfte T, Møller N, Christiansen J S, Klausen I C, Jørgensen J O
Department of Medicine M (Endocrinology and Diabetes), Aarhus University Hospital, Denmark.
Metabolism. 1996 Aug;45(8):1016-20. doi: 10.1016/s0026-0495(96)90273-5.
The role of growth hormone (GH) and thyroid hormone in the regulation of lipid and lipoprotein metabolism is not fully established. Furthermore, the possible linkage between the well-known GH-induced increase in peripheral thyroxine (T4) to triiodothyronine (T3) generation and the effects of GH on lipid and lipoprotein metabolism has not been elucidated. In this double-blind placebo-controlled study, we compared the effects of GH and T3 administration alone and in combination on lipid and lipoprotein metabolism in a group of healthy young adults. The dose of T3 was selected to mimic the T2 increase seen during exogenous GH exposure. Eight normal male subjects (aged 21 to 27 years; body mass index, 21.11 to 27.17 kg/m2) were randomly studied during four 10-day treatment periods with (1) daily subcutaneous placebo injections and placebo injections and placebo tablets, (2) daily subcutaneous GH injections (0.1 IU/kg.d) and placebo tablets, (3) daily T3 administration (40 micrograms on even dates or 20 micrograms on uneven dates) plus placebo injections, and (4) daily GH injections plus T3 administration. GH administration increased free T3 (FT3) to the same level as during T3 administration. GH caused decreased levels of total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol and increased levels of triglycerides (TG) and lipoprotein(a) (Lp(a)), but no changes in high-density lipoprotein (HDL) cholesterol and apolipoprotein B (apo B). T3 administration caused no alteration in these parameters, except for decreased levels of TC comparable to those seen after GH administration. Combined GH and T3 administration caused changes identical to those seen after GH administration, in addition to decreased apo B levels and a further decrease of TC levels. We conclude that GH and iodothyronines in the physiologic range exert distinct but disparate effects on lipids and lipoproteins, and do not support the hypothesis that the effects observed during GH administration are exclusively secondary to changes in peripheral T3 levels.
生长激素(GH)和甲状腺激素在脂质及脂蛋白代谢调节中的作用尚未完全明确。此外,GH诱导外周甲状腺素(T4)转化为三碘甲状腺原氨酸(T3)增加与GH对脂质及脂蛋白代谢的影响之间可能存在的联系也尚未阐明。在这项双盲安慰剂对照研究中,我们比较了单独及联合给予GH和T3对一组健康年轻成年人脂质及脂蛋白代谢的影响。T3的剂量选择旨在模拟外源性GH暴露期间出现的T3增加。八名正常男性受试者(年龄21至27岁;体重指数,21.11至27.17kg/m²)在四个为期10天的治疗期内接受随机研究,治疗分别为:(1)每日皮下注射安慰剂及口服安慰剂片;(2)每日皮下注射GH(0.1IU/kg.d)及口服安慰剂片;(3)每日给予T3(偶数日40微克或奇数日20微克)加皮下注射安慰剂;(4)每日皮下注射GH加给予T3。给予GH使游离T3(FT3)升高至与给予T3时相同的水平。GH导致总胆固醇(TC)和低密度脂蛋白(LDL)胆固醇水平降低,甘油三酯(TG)和脂蛋白(a)[Lp(a)]水平升高,但高密度脂蛋白(HDL)胆固醇和载脂蛋白B(apo B)无变化。给予T3除了使TC水平降低至与给予GH后相当的水平外,对这些参数无改变。联合给予GH和T3除了使apo B水平降低和TC水平进一步降低外,引起的变化与给予GH后相同。我们得出结论,生理范围内的GH和碘甲状腺原氨酸对脂质和脂蛋白具有不同但有差异的作用,并且不支持GH给药期间观察到的效应完全继发于外周T3水平变化的假说。