Metabolic disorders in adult growth hormone deficiency: A study of 110 patients at a single institute in Japan
Metabolic disorders in adult growth hormone deficiency: A study of 110 patients at a single institute in Japan
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DOI：
10.1507/endocrj.k03-115
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发表时间：
2006-08-01
影响因子：
2
通讯作者：
Takano, Kazue
中科院分区：
文献类型：
--
作者：
Itoh, Emina;Hizuka, Naomi;Takano, Kazue
这项在日本一家研究所进行的研究的目的是调查成人生长激素缺乏症 (GHD) 患者的临床特征和并发症。对 1990 年至 1999 年间东京女子医科大学就读的 110 名成人 GHD 患者（50 名男性，60 名女性；平均年龄 42 +/- 17 岁）的临床和生化数据进行回顾性分析。这项回顾性分析表明，109 名患者患有多种垂体激素缺乏症，其中 98 名患者缺乏三种以上激素。 61 名患者患有儿童期发病的 GHD (COGHD)，而其余 49 名患者患有成年期发病的 GHD (AOGHD)。体重指数 (BMI) 范围为 16.9 至 35.9，平均值为 23.9 +/- 4.1 (kg/m(2))，其中 38 名患者（31% 为 COGHD，38% 为 AOGHD）BMI ≥ 25 kg/m(2)。 41% 的患者患有高胆固醇血症，41% 患有高甘油三酯血症，47% 的高密度脂蛋白胆固醇水平降低，48% 的低密度脂蛋白胆固醇水平升高。研究人员对 33 名患者的颈动脉内膜中层厚度 (IMT) 进行了研究，发现异常结果，包括 18 名 COGHD 患者中的 4 名和 15 名 AOGHD 患者中的 4 名观察到 IMT 或斑块增加。 4 名 COGHD 患者和 16 名 AOGHD 患者发现糖尿病和糖耐量受损。通过稳态模型胰岛素抵抗指数（HOMA-R）评估了 36 名患者的胰岛素抵抗，范围为 0.65 至 10.58，平均值为 2.80 +/- 0.37。 HOMA-R 的平均值显着高于正常受试者的测量值（1.58 +/- 0.05：P < 0.05）。这些数据表明，成人 GHD 患者经常出现脂质和葡萄糖代谢异常以及动脉粥样硬化变化。胰岛素抵抗可能在与 GHD 相关的葡萄糖和脂质代谢紊乱中发挥作用。
The purpose of this study carried out at a single institute in Japan was to investigate the clinical characteristics and complications of patients with adult growth hormone deficiency (GHD). Clinical and biochemical data of 110 patients (50 males, 60 females; mean age 42 +/- 17 yr) with adult GHD who attended Tokyo Women's Medical University between 1990 and 1999 were analyzed retrospectively from medical records. This retrospective analysis demonstrated that 109 patients had multiple pituitary hormone deficiencies, with 98 patients having a deficiency of more than three hormones. Sixty-one patients had childhood onset GHD (COGHD) while the remaining 49 patients had adulthood onset GHD (AOGHD). Body mass index (BMI) ranged from 16.9 to 35.9 with a mean of 23.9 +/- 4.1 (kg/m(2)), with BMI being >= 25 kg/m(2) in 38 patients (31% of COGHD and 38% of AOGHD). Forty-one percent of the patients had hypercholesterolemia, 41% had hypertriglyceridernia, 47% had decreased levels of HDL cholesterol and 48% had increased levels of LDL cholesterol. Intima-media thickness (IMT) of the carotid arteries was investigated in 33 patients, with abnormal findings including increased IMT or plaque being observed in 4 of 18 COGHD patients and 4 of 15 AOGHD patients. Diabetes mellitus and impaired glucose tolerance was found in 4 COGHD patients and 16 AOGHD patients. Insulin resistance was assessed in 36 patients by the homeostasis model insulin resistance index (HOMA-R) and ranged from 0.65 to 10.58 with a mean of 2.80 +/- 0.37. This mean value of HOMA-R was significantly greater than that measured in normal subjects (1.58 +/- 0.05: P < 0.05). These data suggest that abnormal lipid and glucose metabolism, and atherosclerotic changes occur frequently in adult patients with GHD. Insulin resistance may play a role in glucose and lipid metabolism disorders associated with GHD.