One year of insulin-like growth factor I treatment does not affect bone density, body composition, or psychological measures in postmenopausal women
One year of insulin-like growth factor I treatment does not affect bone density, body composition, or psychological measures in postmenopausal women
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DOI：
10.1210/jc.86.4.1496
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发表时间：
2001-04-01
影响因子：
5.8
通讯作者：
Hoffman, AR
中科院分区：
文献类型：
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作者：
Friedlander, AL;Butterfield, E;Hoffman, AR
下丘脑-GH-胰岛素样生长因子I（下丘脑-GH IGF-I）轴的活性随着年龄的增长而下降，衰老的一些分解代谢变化归因于躯体停顿。本研究的目的是确定IGF-I激素替代治疗1年对健康、非肥胖、60岁以上绝经后妇女的身体成分、骨密度和心理参数的影响。受试者（n = 16，70.6 +/-2.0岁，71.8 +/-2.8 kg）被随机分配到自我注射IGF-I（15 μ g/kg，每日两次）或安慰剂组，并在基线、6个月和1年治疗时进行研究。IGF-I组和安慰剂组在基线时的任何测量变量均无显著差异。IGF-I治疗组6个月（330.0 +/-52.8）和12个月（297.7 +/-40.8）时空腹血IGF-I水平显著高于基线值（65.6 +/-11.9 ng/mL），但安慰剂组受试者未发生变化。IGF结合蛋白-1和-3的循环水平不受IGF-I治疗的影响。两组前臂、腰椎、髋部和全身的骨密度[通过双能X线吸收测定法（DXA）测量]均无变化。同样，在整个治疗干预过程中，DXA测量的瘦体重、脂肪量或体脂百分比没有差异。肌肉力量值（握力、卧推、腿部推举）、血脂参数（胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯）和餐后葡萄糖处置的测量值未被IGF-I治疗改变，尽管12个月时IGF-I受试者的餐后胰岛素水平较低。IGF-I不影响骨转换标志物（骨钙素和I型胶原N-端肽），但在基线、6个月和12个月时，服用雌激素的受试者的骨转换标志物显著低于未服用雌激素的受试者。最后，情绪和记忆的心理测量也没有被干预改变。尽管最初打算招募更多受试者，但在16例受试者完成方案后，研究终止，因为上述初步分析表明，无论治疗方案如何，任何结局变量均未发生变化。因此，我们得出结论，1年的IGF-I治疗，在剂量足以提高循环IGF-I年轻的正常值，是不是一个有效的手段来改变身体成分或血液参数，也没有改善骨密度，强度，情绪，或老年妇女的记忆。
The activity of the hypothalamic-GH-insulin-like growth factor I (hypothalamic-GH IGF-I) axis declines with age, and some of the catabolic changes of aging have been attributed to the somato-pause. The purpose of this investigation was to determine the impact of 1 yr of IGF-I hormone replacement therapy on body composition, bone density, and psychological parameters in healthy, nonobese, postmenopausal women over 60 yr of age. Subjects (n = 16, 70.6 +/- 2.0 yr, 71.8 +/- 2.8 kg) were randomly assigned to either the self-injection IGF-I (15 mug/kg twice daily) or placebo group and were studied at baseline, at 6 months, and at 1 yr of treatment. There were no significant differences between the IGF-I and placebo groups in any of the measured variables at baseline. Fasting blood IGF-I levels were significantly elevated above baseline values (65.6 +/- 11.9 ng/mL) at 6 months (330.0 +/- 52.8) and 12 months (297.7 +/- 40.8) in the IGF-I treated group but did not change in the placebo subjects. Circulating levels of IGF-binding protein-1 and -3 were unaffected by the IGF-I treatment. Bone mineral density of the forearm, lumbar spine, hip, and whole body [as measured by dual-energy x-ray absorptiometry (DXA)] did not change in either group. Similarly, there was no difference in DXA- measured lean mass, fat mass, or percent body fat throughout the treatment intervention. Muscle strength values (grip, bench press, leg press), blood lipid parameters (cholesterol, high-density lipoprotein, low-density lipoprotein, triglycerides), and measures of postmeal glucose disposal were not altered by IGF-I treatment, although postmeal insulin levels were lower in the IGF-I subjects at 12 months. IGF-I did not affect bone turnover markers (osteocalcin and type I collagen N-teleopeptide), but subjects who were taking estrogen had significantly lower turnover markers than subjects who were not on estrogen at baseline, 6 months, and 12 months. Finally, the psychological measures of mood and memory were also not altered by the intervention. Despite the initial intent to recruit additional subjects, the study was discontinued after 16 subjects completed the protocol, because the preliminary analyses above indicated that no changes were occurring in any outcome variables, regardless of treatment regimen. Therefore, we conclude that 1 yr of IGF-I treatment, at a dose sufficient to elevate circulating IGF-I to young normal values, is not an effective means to alter body composition or blood parameters nor improve bone density, strength, mood, or memory in older women.