Kuromaru R, Kohno H, Ueyama N, Hassan H M, Honda S, Hara T
Department of Endocrinology and Metabolism, Fukuoka Children's Hospital, Faculty of Medicine, Kyushu University, Japan.
J Clin Endocrinol Metab. 1998 Nov;83(11):3890-6. doi: 10.1210/jcem.83.11.5261.
GH has many effects on metabolism in addition to promoting growth. We studied changes in body composition and lipid profiles during and after GH treatment in 94 children with GH deficiency. Sixty-two subjects (46 boys and 16 girls) were evaluated at the beginning and during 36 months of GH treatment. The other 32 (21 boys and 11 girls) who had already been treated with GH were examined after the discontinuation of GH for a 6-month period. The height SD scores at the beginning and the discontinuation of GH treatment were -2.81 and -1.34 in boys and -3.14 and -1.38 in girls, respectively. The percent body fat (BF) significantly decreased from 16.5% to 11.7% in boys and from 16.7% to 11.6% in girls during the first 6 months of GH treatment (P < 0.01). BF subsequently remained constant in boys, but started to increase in girls from the 18th month of treatment. Lean body mass (kilograms) increased linearly throughout the treatment in both sexes (P < 0.01). Mean total cholesterol (TC) values decreased as a result of marked declines in low density lipoprotein cholesterol in both sexes, although statistical significance was detected only in boys (P < 0.01). High density lipoprotein cholesterol (HDLC) and apolipoprotein AI (Apo-AI) rapidly increased only in boys (P < 0.01). Triglyceride, Apo-AII, Apo-B, Apo-CII, Apo-CIII, Apo-E, and lipoprotein(a) showed no significant changes compared with baseline levels. Mean TC/HDLC and Apo-B/Apo-AI ratios decreased during treatment in both sexes, but the difference from baseline was significant only in boys (P < 0.01). After discontinuation of GH treatment, BF increased, and lean body mass decreased in boys (P < 0.01), whereas these variables did not change in girls. TC and low density lipoprotein cholesterol increased in boys within 6 months of discontinuing GH (P < 0.05). Other lipoproteins did not change in either sex, except for lipoprotein(a), which decreased significantly 6 months after the cessation of GH treatment in boys (P < 0.01). The mean TC/HDLC and Apo-B/Apo-AI ratios increased in boys slightly, but insignificantly. We concluded that GH treatment has beneficial effects on body composition and lipid profiles in both boys and girls with GH deficiency, although there are considerable gender differences. These beneficial effects of GH were reversed after the discontinuation of GH treatment, suggesting an important role of GH for GH-deficient children in the maintenance of normal metabolism even after the completion of linear growth.
除了促进生长外，生长激素（GH）对新陈代谢也有多种影响。我们研究了94例生长激素缺乏儿童在接受生长激素治疗期间及治疗后的身体成分和血脂谱变化。62名受试者（46名男孩和16名女孩）在生长激素治疗开始时及治疗36个月期间接受评估。另外32名（21名男孩和11名女孩）已经接受过生长激素治疗的受试者在停用生长激素6个月后接受检查。生长激素治疗开始时和结束时，男孩的身高标准差分数分别为-2.81和-1.34，女孩分别为-3.14和-1.38。在生长激素治疗的前6个月，男孩的体脂百分比（BF）从16.5%显著降至11.7%，女孩从16.7%降至11.6%（P<0.01）。随后男孩的体脂百分比保持稳定，但女孩从治疗第18个月开始上升。在整个治疗过程中，两性的去脂体重（千克）均呈线性增加（P<0.01）。由于两性的低密度脂蛋白胆固醇均显著下降，平均总胆固醇（TC）值降低，不过仅在男孩中检测到统计学显著性（P<0.01）。高密度脂蛋白胆固醇（HDLC）和载脂蛋白AI（Apo-AI）仅在男孩中迅速升高（P<0.01）。甘油三酯、Apo-AII、Apo-B、Apo-CII、Apo-CIII、Apo-E和脂蛋白（a）与基线水平相比无显著变化。治疗期间，两性的平均TC/HDLC和Apo-B/Apo-AI比值均下降，但仅在男孩中与基线的差异具有显著性（P<0.01）。停用生长激素治疗后，男孩的体脂百分比增加，去脂体重减少（P<0.01），而女孩的这些变量没有变化。停用生长激素后6个月内，男孩的TC和低密度脂蛋白胆固醇升高（P<0.05）。除脂蛋白（a）外，其他脂蛋白在两性中均无变化，男孩在停用生长激素治疗6个月后脂蛋白（a）显著下降（P<0.01）。男孩的平均TC/HDLC和Apo-B/Apo-AI比值略有升高，但无显著性。我们得出结论，生长激素治疗对生长激素缺乏的男孩和女孩的身体成分和血脂谱均有有益影响，尽管存在相当大的性别差异。生长激素治疗停止后，这些有益作用被逆转，这表明生长激素对生长激素缺乏儿童即使在线性生长完成后维持正常新陈代谢也起着重要作用。
