Wildbrett J, Hanefeld M, Fücker K, Pinzer T, Bergmann S, Siegert G, Breidert M
Institute and Outpatient Department for Clinical Metabolic Research, Medical Faculty Carl Gustav Carus, Technical University Dresden, Germany.
Exp Clin Endocrinol Diabetes. 1997;105(6):331-5. doi: 10.1055/s-0029-1211774.
The influence of hGH and IGF-I levels on lipid-, lipoprotein metabolism and fibrinolysis were studied in 23 patients with active acromegaly (14 women and 9 men, mean age 49.8 +/- 2.1 years) compared to a sex, BMI and age-matched control group. Mean Lp(a) levels were significantly higher in acromegalics than in controls (469.8 +/- 140.1; n = 23 vs. 162.7 +/- 64.9 mg/l; n = 111; p < 0.01). We found elevated apolipoprotein A-I and Apo E-concentrations in acromegalic patients compared to controls (apo A-I: 1.79 +/- 0.06 vs. 1.46 +/- 0.04 g/l; p < 0.01; apo E: 98.35 +/- 6.4 vs. 72.53 +/- 3.38 mg/l; p < 0.05). 30% of the acromegalics showed increased plasminogen activator inhibitor activity (PAI) while 66% had increased tissue-type plasminogen activator (t-PA) concentrations. There was a correlation between hGH and Lp(a) (r = 0.414; p = 0.05), between hGH and PAI (r = -0.59; p < 0.005) and IGF-I and t-PA activity (r = -0.44; p < 0.05). In a subgroup of nine acromegalics Lp(a) was reduced by 32.2 +/- 6.7% (p < 0.05) after a six-month octreotide therapy and HDL2-cholesterol-concentration increased from 0.17 +/- 0.04 to 0.24 +/- 0.04 mmol/l (p < 0.05). In conclusion, our results demonstrate that elevated Lp(a)-concentrations and changes in fibrinolysis contribute to the cardiovascular complications and should therefore be controlled in acromegalic patients.
与性别、体重指数（BMI）和年龄匹配的对照组相比，研究了生长激素（hGH）和胰岛素样生长因子-I（IGF-I）水平对23例活动性肢端肥大症患者（14名女性和9名男性，平均年龄49.8±2.1岁）脂质、脂蛋白代谢及纤维蛋白溶解的影响。肢端肥大症患者的平均脂蛋白（a）[Lp（a）]水平显著高于对照组（469.8±140.1；n = 23 vs. 162.7±64.9 mg/l；n = 111；p < 0.01）。我们发现，与对照组相比，肢端肥大症患者的载脂蛋白A-I和载脂蛋白E浓度升高（载脂蛋白A-I：1.79±0.06 vs. 1.46±0.04 g/l；p < 0.01；载脂蛋白E：98.35±6.4 vs. 72.53±3.38 mg/l；p < 0.05）。30%的肢端肥大症患者纤溶酶原激活物抑制剂活性（PAI）增加，而66%的患者组织型纤溶酶原激活物（t-PA）浓度增加。hGH与Lp（a）之间存在相关性（r = 0.414；p = 0.05），hGH与PAI之间存在相关性（r = -0.59；p < 0.005），IGF-I与t-PA活性之间存在相关性（r = -0.44；p < 0.05）。在9例肢端肥大症患者的亚组中，经过6个月的奥曲肽治疗后，Lp（a）降低了32.2±6.7%（p < 0.05），高密度脂蛋白2（HDL2）胆固醇浓度从0.17±0.04 mmol/l增加到0.24±0.04 mmol/l（p < 0.05）。总之，我们的结果表明，Lp（a）浓度升高和纤维蛋白溶解的变化会导致心血管并发症，因此在肢端肥大症患者中应加以控制。
