Bowes S B, Umpleby M, Cummings M H, Jackson N C, Carroll P V, Lowy C, Sönksen P H, Russell-Jones D L
Department of Medicine, United Medical, School, Guys Hospital, London, United Kingdom.
J Clin Endocrinol Metab. 1997 Jan;82(1):243-6. doi: 10.1210/jcem.82.1.3690.
Cushing's syndrome is characterized by central obesity and muscle wasting. As GH is anabolic, it may be able to counteract the loss of body protein. To evaluate the potential therapeutic use of GH preoperatively, eight patients with Cushing's syndrome received sc injections of recombinant human GH (0.07 U/kg.day) for 7 days. Whole body leucine and glucose turnover were measured after an infusion of [1-13C]leucine and [6,6-2H2]glucose before (day 0) and after 2 and 7 days of GH treatment. Compared with the value on day 0, there was a significant increase on days 2 and 7 in insulin (P < 0.005 and P < 0.001), C peptide (P < 0.01 and P < 0.005), insulin-like growth factor I (P < 0.001), and glucose concentrations (P < 0.01 and P < 0.005) and a decrease in the leucine concentration (P < 0.005). There was no significant change in glucose production rate, glucose MCR, leucine production rate (a measure of protein degradation), or nonoxidative leucine disappearance rate (a measure of protein synthesis). The leucine MCR was increased after 7 days (P < 0.05), and the clearance of leucine into protein (nonoxidative leucine disappearance rate/leucine concentration) was increased (P < 0.05) after 2 and 7 days of GH treatment. This is consistent with GH stimulating the availability of amino acid transporters. GH may, therefore, have a therapeutic role in the preoperative treatment of Cushing's syndrome.
库欣综合征的特征为向心性肥胖和肌肉萎缩。由于生长激素具有合成代谢作用，它可能能够抵消身体蛋白质的流失。为了评估术前生长激素的潜在治疗用途，8例库欣综合征患者皮下注射重组人生长激素（0.07 U/kg·天），共7天。在生长激素治疗前（第0天）以及治疗2天和7天后，输注[1-¹³C]亮氨酸和[6,6-²H₂]葡萄糖后，测量全身亮氨酸和葡萄糖周转率。与第0天的值相比，胰岛素（P < 0.005和P < 0.001）、C肽（P < 0.01和P < 0.005）、胰岛素样生长因子I（P < 0.001）和葡萄糖浓度（P < 0.01和P < 0.005）在第2天和第7天显著升高，亮氨酸浓度降低（P < 0.005）。葡萄糖生成率、葡萄糖代谢清除率、亮氨酸生成率（蛋白质降解的指标）或非氧化亮氨酸消失率（蛋白质合成的指标）无显著变化。亮氨酸代谢清除率在7天后升高（P < 0.05），生长激素治疗2天和7天后，亮氨酸进入蛋白质的清除率（非氧化亮氨酸消失率/亮氨酸浓度）升高（P < 0.05）。这与生长激素刺激氨基酸转运体的可用性一致。因此，生长激素可能在库欣综合征的术前治疗中具有治疗作用。
