Amato G, Izzo G, Salzano I, Bellastella A
Cattedra di Endocrinologia, Facoltà di Medicina e Chirurgia, Seconda Università di Napoli, Italy.
J Endocrinol Invest. 1996 Sep;19(8):563-6. doi: 10.1007/BF03349017.
Pituitary-thyroid changes have been reported during recombinant human growth hormone (rhGH) therapy at the dose commonly used in prepuberty. We have previously demonstrated that low doses of rhGH were able to normalize body composition and both cardiac structure and function in growth hormone deficient adults (GHDA), without causing any of the side effects described when the GHDA were treated with doses commonly employed in the GHD children. The aim of this study was to evaluate the behaviour of pituitary-thyroid parameters in GHDA undergoing such a low dose of rhGH treatment. We studied 9 (2 females and 7 males, 25-34 yr) GHDA, 7 congenital and 2 acquired GH deficiency, before, during and after a 12-month rhGH treatment of dose of 10 micrograms/kg/day (= 70 micrograms/kg/week) divided in 3 injections, administered sc at 20:00 h on Monday, Wednesday and Friday, respectively. Thyroid deficiency and other hormonal deficiencies, when present, had been adequately corrected with replacement therapy. Serum IGF1, T3, T4, free-T3, free-T4, TSH, reverse-T3, T3/T4 and FT3/FT4 ratios were studied basally, every 3 months during the 12-month rhGH treatment and every 3 months for a period of 12 months off therapy. Analysis of variance (ANOVA) was performed as statistical method. All parameters (except IGF1) did not show any variation during and after rhGH treatment at low doses. The alterations of T3 and T4 metabolism, in the sense of a T3 increase and a T4 reduction, caused sometimes by rhGH treatment, could be due to the higher doses used and therefore should be considered another side effect, like artrhalgia, fluid retention, carpal tunnel syndrome, etc.
垂体-甲状腺变化在青春期前常用剂量的重组人生长激素（rhGH）治疗期间已有报道。我们之前已经证明，低剂量的rhGH能够使生长激素缺乏的成年人（GHDA）的身体成分以及心脏结构和功能恢复正常，且不会引起在用GHD儿童常用剂量治疗GHDA时所描述的任何副作用。本研究的目的是评估接受这种低剂量rhGH治疗的GHDA中垂体-甲状腺参数的变化情况。我们研究了9名（2名女性和7名男性，年龄25 - 34岁）GHDA患者，其中7例为先天性生长激素缺乏，2例为后天性生长激素缺乏，在接受为期12个月、剂量为10微克/千克/天（= 70微克/千克/周）的rhGH治疗前、治疗期间和治疗后进行观察。该剂量分3次注射，分别于周一、周三和周五晚上8点皮下注射。甲状腺功能减退和其他激素缺乏症（如有）已通过替代疗法得到充分纠正。在rhGH治疗的12个月期间，每3个月以及在停药后的12个月期间，每3个月研究一次血清IGF1、T3、T4、游离T3、游离T4、TSH、反T3、T3/T4和FT3/FT4比值。采用方差分析（ANOVA）作为统计方法。所有参数（IGF1除外）在低剂量rhGH治疗期间及治疗后均未显示任何变化。rhGH治疗有时会引起T3和T4代谢的改变，表现为T3升高和T4降低，这可能是由于使用的剂量较高，因此应将其视为另一种副作用，如关节痛、液体潴留、腕管综合征等。
