Jockenhövel F, Rohrbach S, Deggerich S, Reinwein D, Reiners C
Klinik II und Poliklinik f-ur Innere Medizin, Universit-at zu K-oln, Joseph-Stelzmann-Str. 9, K-oln D-50924, Germany.
Eur J Med Res. 1996 May 24;1(8):377-82.
Growth hormone (GH) has been suggested as a therapeutic tool for the treatment of osteopenia. To assess the differential influence of growth hormone on cortical and trabecular bone, bone mineral densities (BMD) of the ultradistal radius were determined in 18 men and 19 women with clinically and biochemically confirmed acromegaly using peripheral computed tomography and a specialized scanner (Stratec XCT 900). The results were expressed in equivalents to hydroxyl-apatite (mg/ccm) and compared with the BMD of healthy controls (17 men, 34 women). Cortical bone mineral density was significantly higher in acromegalic women (295.2 +/- 18.4, X +/- SEM) and men (339.4 +/- 21.2) compared to healthy women (243.0 +/- 12.8) and men (272.2 +/- 15.9). In contrast, trabecular BMD did not differ between acromegalic patients (men: 161.0 +/- 16.1; women: 116.5 +/- 10.5) and controls (men: 158.0 +/- 12.2; women: 134.1 +/- 6.3). Acromegalic women showed a significant correlation between insulin-like growth factor (IGF-I) expression and cortical BMD, whereas in acromegalic men GH levels correlated significantly with cortical BMD. Greatly increased serum osteocalcin levels in both, acromegalic men (15.5 +/- 3.3 ng/ml) and women (12.9 +/- 1.8) compared to controls (men: 6.7 +/- 1.7; women: 7.7 +/- 1.0) indicates the activation of osteoblastic bone formation. This study revealed an increase in cortical BMD at the forearm; in acromegalic patients; though trabecular BMD did not differ from controls. The differential mineralization of cortical and trabecular bone in acromegaly may be indicative of the detrimental effect accompanying pituitary insufficiency can have on trabecular bone, despite substitution therapy, but could also be due to different reactivity of cortical and trabecular bone to GH and/or IGF I. The observable increase of bone mineral density in acromegaly suggests a potential use for GH in treating osteoporosis.
生长激素（GH）已被提议作为治疗骨质减少的一种治疗手段。为了评估生长激素对皮质骨和小梁骨的不同影响，使用外周计算机断层扫描和一台专用扫描仪（Stratec XCT 900），对18名男性和19名临床及生化确诊为肢端肥大症的女性的桡骨远端超远端骨矿物质密度（BMD）进行了测定。结果以羟基磷灰石当量（mg/ccm）表示，并与健康对照者（17名男性，34名女性）的BMD进行比较。与健康女性（243.0±12.8）和男性（272.2±15.9）相比，肢端肥大症女性（295.2±18.4，X±SEM）和男性（339.4±21.2）的皮质骨矿物质密度显著更高。相比之下，肢端肥大症患者（男性：161.0±16.1；女性：116.5±10.5）与对照组（男性：158.0±12.2；女性：134.1±6.3）之间的小梁BMD没有差异。肢端肥大症女性的胰岛素样生长因子（IGF-I）表达与皮质BMD之间存在显著相关性，而在肢端肥大症男性中，GH水平与皮质BMD显著相关。与对照组（男性：6.7±1.7；女性：7.7±1.0）相比，肢端肥大症男性（15.5±3.3 ng/ml）和女性（12.9±1.8）的血清骨钙素水平大幅升高，表明成骨细胞骨形成被激活。这项研究揭示了肢端肥大症患者前臂皮质BMD增加；尽管小梁BMD与对照组没有差异。肢端肥大症中皮质骨和小梁骨的矿化差异可能表明，尽管进行了替代治疗，但垂体功能不全对小梁骨可能产生有害影响，也可能是由于皮质骨和小梁骨对GH和/或IGF-I的反应不同。肢端肥大症中可观察到的骨矿物质密度增加表明GH在治疗骨质疏松症方面具有潜在用途。
