重组生长激素（GH）治疗对童年期起病的生长激素缺乏症成人骨矿物质密度和身体成分的影响。

Effects of recombinant growth hormone (GH) treatment on bone mineral density and body composition in adults with childhood onset growth hormone deficiency.

作者信息

Sartorio A, Ortolani S, Conti A, Cherubini R, Galbiati E, Faglia G

机构信息

Centro Auxologico Italiano, IRCCS, Milano, Italy.

出版信息

J Endocrinol Invest. 1996 Sep;19(8):524-9. doi: 10.1007/BF03349011.

DOI:10.1007/BF03349011

PMID:8905475

Abstract

Lumbar spine, whole proximal femur and total body bone mineral density (BMD, g/cm2) and the regional soft tissue composition were measured with dual energy X-ray absorptiometry (Hologic QDR 1000/W) in eight adults with childhood onset GHD, before and after 6 months of recombinant GH treatment (0.5 IU/kg/week). Data obtained from patients were compared with those recorded in an age and sex matched control group. Before treatment, lumbar (L2-L4) spine BMD (mean +/- SD: 0.811 +/- 0.159 g/cm2), whole proximal femur BMD (0.739 +/- 0.094 g/cm2) and total body BMD (0.946 +/- 0.087 g/cm2) of patients were significantly (p < 0.001, 0.01 and 0.001, respectively) lower than those recorded in an age- and sex-matched control group (1.077 +/- 0.155 g/cm2, 0.968 +/- 0.166 g/cm2 and 1.168 +/- 0.058 g/cm2, respectively), although three patients showed BMD values at the lower limit of the normal range. Mean lumbar spine BMD, whole proximal femur BMD and total body BMD did not significantly change alter 6 months' GH treatment (-1.4 +/- 3.7%, +2.7 +/- 3.7% and -1.1 +/- 5.0% vs basal values, respectively). On the other hand, trochanteric subregion showed a significant 4.8 +/- 5.3% increase (vs basal, p < 0.05), while other hip subregions did not show significant changes. GH therapy caused marked effects on body composition; in fact, a significant decrease (p < 0.01) of trunk fat (-25.2 +/- 15.0%) and a marked increase (p < 0.01) of limbs lean mass (+10.0 +/- 5.3%), resulting in a significant (p < 0.02) reduction (-16.5 +/- 13.5%) of the axial to peripheral fat ratio (APFR), were clearly evident after six months of therapy. In conclusion, our study shows that six months of GH treatment do not exert relevant effects on the BMD of adults with childhood onset GHD. On the contrary, the effects of GH therapy on body composition are more marked, being clearly appreciable after six months of treatment.

摘要

采用双能X线吸收法（Hologic QDR 1000/W）对8例儿童期起病的生长激素缺乏症（GHD）成人患者在重组生长激素治疗（0.5 IU/kg/周）6个月前后测量腰椎、整个近端股骨及全身的骨矿物质密度（BMD，g/cm²）和局部软组织成分。将患者的数据与年龄和性别匹配的对照组记录的数据进行比较。治疗前，患者的腰椎（L2-L4）骨密度（均值±标准差：0.811±0.159 g/cm²）、整个近端股骨骨密度（0.739±0.094 g/cm²）和全身骨密度（0.946±0.087 g/cm²）显著低于（分别为p<0.001、0.01和0.001）年龄和性别匹配的对照组（分别为1.077±0.155 g/cm²、0.968±0.166 g/cm²和1.168±0.058 g/cm²），尽管3例患者显示骨密度值在正常范围下限。生长激素治疗6个月后，腰椎平均骨密度、整个近端股骨骨密度和全身骨密度无显著变化（分别相对于基础值为-1.4±3.7%、+2.7±3.7%和-1.1±5.0%）。另一方面，转子亚区显著增加4.8±5.3%（相对于基础值，p<0.05），而其他髋部亚区无显著变化。生长激素治疗对身体成分有显著影响；事实上，治疗6个月后，躯干脂肪显著减少（p<0.01）（-25.2±15.0%），肢体瘦体重显著增加（p<0.01）（+10.0±5.3%），导致轴向与外周脂肪比（APFR）显著降低（p<0.02）（-16.5±13.5%）。总之，我们的研究表明，6个月的生长激素治疗对儿童期起病的生长激素缺乏症成人患者的骨密度没有显著影响。相反，生长激素治疗对身体成分的影响更为显著，治疗6个月后即可明显看出。