生物合成人生长激素（GH）对垂体功能减退性生长激素缺乏症成年患者进行四年治疗对身体成分的影响。

Effects of four years' treatment with biosynthetic human growth hormone (GH) on body composition in GH-deficient hypopituitary adults.

作者信息

Al-Shoumer K A, Page B, Thomas E, Murphy M, Beshyah S A, Johnston D G

机构信息

Unit of Metabolic Medicine, Imperial College School of Medicine at St Mary's Hospital, London, UK.

出版信息

Eur J Endocrinol. 1996 Nov;135(5):559-67. doi: 10.1530/eje.0.1350559.

DOI:10.1530/eje.0.1350559

PMID:8980158

Abstract

Short-term trials of growth hormone (GH) substitution in hypopituitary adults have shown beneficial effects on body composition. To evaluate the long-term effects on body composition, we followed thirteen GH-deficient adults (GH < 6 mU/l following standard provocative tests) for 4 years of GH replacement. At yearly intervals, serum insulin-like growth factor I (IGF-I), body weight, body mass index (BMI), waist, waist-to-hip circumference ratio (WHR) and resting systolic (SBP) and diastolic blood pressure (DBP) were determined, and body composition was assessed using three independent methods: total body potassium (TBK), bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). Compared to baseline, IGF-I levels increased significantly at 1 (p = 0.0001), 2 (p = 0.0004), 3 (p = 0.006) and 4 years (p = 0.002). Body weight and BMI changed minimally at 1, 2 and 3 years and increased significantly only at the fourth year (p = 0.012 and p = 0.0009, respectively) of GH therapy. Waist and WHR decreased significantly at 1, 2 and 4 years (waist: p = 0.0009, p = 0.0004, p = 0.049; WHR: p = 0.0025, p = 0.012, p = 0.047, respectively). Neither resting SBP nor DBP changed significantly. Fat-free mass (FFM) derived from TBK and BIA increased significantly at 1 (p = 0.004; p = 0.004), 2 (p = 0.003; p = 0.05), 3 (p = 0.005; p = 0.04) and 4 years (p = 0.02; p = 0.002). Using DXA, the increase in FFM was significant at 1 (p = 0.007) and 2 years (p = 0.008) but not at 3 and 4 years. Percentage body fat measured by TBK, BIA and DXA decreased significantly at 1 (p = 0.008; p = 0.003; p = 0.03), 2 (p = 0.018; p = 0.06; p = 0.049) and 4 years (p = 0.03; p = 0.002; p = 0.04). A rise in total body water, calculated from BIA, was observed at 1 year (p = 0.004) and was maintained throughout the treatment period. These data demonstrate that 4 years of GH treatment in hypopituitary adults is associated with sustained improvement in body composition.

摘要

对垂体功能减退的成年人进行生长激素（GH）替代治疗的短期试验显示，其对身体成分有有益影响。为评估对身体成分的长期影响，我们对13名生长激素缺乏的成年人（标准激发试验后GH<6 mU/l）进行了4年的GH替代治疗随访。每年测定血清胰岛素样生长因子I（IGF-I）、体重、体重指数（BMI）、腰围、腰臀围比（WHR）以及静息收缩压（SBP）和舒张压（DBP），并使用三种独立方法评估身体成分：全身钾（TBK）、生物电阻抗分析（BIA）和双能X线吸收法（DXA）。与基线相比，IGF-I水平在第1年（p = 0.0001）、第2年（p = 0.0004）、第3年（p = 0.006）和第4年（p = 0.002）显著升高。体重和BMI在第1、2和3年变化极小，仅在GH治疗的第4年显著增加（分别为p = 0.012和p = 0.0009）。腰围和WHR在第1、2和4年显著降低（腰围：p = 0.0009，p = 0.0004，p = 0.049；WHR：分别为p = 0.0025，p = 0.012，p = 0.047）。静息SBP和DBP均无显著变化。源自TBK和BIA的去脂体重（FFM）在第1年（p = 0.004；p = 0.004）、第2年（p = 0.003；p = 0.05）、第3年（p = 0.005；p = 0.04）和第4年（p = 0.02；p = 0.002）显著增加。使用DXA时，FFM在第1年（p = 0.007）和第2年（p = 0.008）显著增加，但在第3年和第4年未增加。通过TBK、BIA和DXA测量的体脂百分比在第1年（p = 0.008；p = 0.003；p = 0.03）、第2年（p = 0.018；p = 0.06；p = 0.049）和第4年（p = 0.03；p = 0.002；p = 0.04）显著降低。由BIA计算得出的全身水含量在第1年升高（p = 0.004），并在整个治疗期间保持。这些数据表明，对垂体功能减退的成年人进行4年的GH治疗与身体成分的持续改善相关。