生长激素替代疗法对生长激素缺乏的成年人进行长达12个月的治疗，其对脂蛋白组成和脂蛋白(a)的影响。

The effect of growth hormone replacement therapy for up to 12 months on lipoprotein composition and lipoprotein(a) in growth hormone-deficient adults.

作者信息

Webster J M, Stewart M, al-Maskari M, Osman I, Kendall-Taylor P, Mitcheson J, Laker M F

机构信息

Department of Clinical Biochemistry, Medical School, Newcastle upon Tyne, UK.

出版信息

Atherosclerosis. 1997 Aug;133(1):115-21. doi: 10.1016/s0021-9150(97)00110-x.

DOI:10.1016/s0021-9150(97)00110-x

PMID:9258415

Abstract

The effect of growth hormone replacement therapy in near physiological doses on lipoprotein composition and serum lipoprotein(a) concentrations was investigated in growth hormone-deficient subjects. A randomised, double-blind, placebo-controlled trial of recombinant growth hormone was undertaken for 6 months followed by an open extension for a further 6 months (0.125 IU/kg per week for the first 4 weeks of each 6 month period and thereafter 0.25 IU/kg per week). A total of 18 patients with isolated growth hormone deficiency or hypopituitarism were studied. Lipid concentrations were estimated in lipoprotein fractions and protein concentrations were measured in low density lipoprotein (LDL). Glucose and glycated haemoglobin in blood and insulin, cholesterol, triglyceride, apolipoproteins A-I and B and lipoprotein(a) concentrations were measured in serum. In the placebo-controlled phase fasting blood glucose concentrations increased with growth hormone treatment from 5.0 +/- 0.2 to 5.8 +/- 0.2 mmol/l (P = 0.02) (mean +/- S.E.M.), although no significant changes were seen in lipids or lipoproteins. In the group receiving active treatment total serum cholesterol decreased from 6.0 +/- 0.4 to 5.2 +/- 0.3 mmol/l (P = 0.002) after 6 months, due to reduced LDL cholesterol concentrations. Low density lipoprotein protein concentrations fell (0.8 +/- 0.1 versus 0.7 +/- 0.1 g/l) (P = 0.005), and LDL phospholipid levels decreased from 0.9 +/- 0.1 to 0.7 +/- 0.1 mmol/l (P = 0.007). Serum cholesterol and LDL composition reverted to pre-treatment values by 12 months. Fasting blood glucose remained above pre-treatment values (P = 0.036) and fasting insulin was significantly increased (P = 0.044). There was no effect of growth hormone therapy on serum triglyceride, apolipoprotein or lipoprotein(a) concentrations. In conclusion, growth hormone therapy with near physiological doses has no long term effects on serum lipoprotein(a) concentrations or lipoprotein composition.

摘要

在生长激素缺乏的受试者中，研究了接近生理剂量的生长激素替代疗法对脂蛋白组成和血清脂蛋白（a）浓度的影响。对重组生长激素进行了一项随机、双盲、安慰剂对照试验，为期6个月，随后进行了为期6个月的开放扩展试验（每6个月周期的前4周为每周0.125 IU/kg，此后为每周0.25 IU/kg）。共研究了18例孤立性生长激素缺乏或垂体功能减退的患者。估计脂蛋白组分中的脂质浓度，并测量低密度脂蛋白（LDL）中的蛋白质浓度。测定血液中的葡萄糖和糖化血红蛋白以及血清中的胰岛素、胆固醇、甘油三酯、载脂蛋白A-I和B以及脂蛋白（a）浓度。在安慰剂对照阶段，生长激素治疗使空腹血糖浓度从5.0±0.2 mmol/l升至5.8±0.2 mmol/l（P = 0.02）（均值±标准误），尽管脂质或脂蛋白未见显著变化。在接受积极治疗的组中，6个月后总血清胆固醇从6.0±0.4 mmol/l降至5.2±0.3 mmol/l（P = 0.002），这是由于LDL胆固醇浓度降低所致。低密度脂蛋白蛋白质浓度下降（0.8±0.1对0.7±0.1 g/l）（P = 0.005），LDL磷脂水平从0.9±0.1 mmol/l降至0.7±0.1 mmol/l（P = 0.007）。血清胆固醇和LDL组成在12个月时恢复到治疗前值。空腹血糖仍高于治疗前值（P = 0.036），空腹胰岛素显著升高（P = 0.044）。生长激素治疗对血清甘油三酯、载脂蛋白或脂蛋白（a）浓度没有影响。总之，接近生理剂量的生长激素治疗对血清脂蛋白（a）浓度或脂蛋白组成没有长期影响。