Fifteen years of GH replacement improves body composition and cardiovascular risk factors.
Fifteen years of GH replacement improves body composition and cardiovascular risk factors.
复制标题
DOI：
10.1530/eje-12-1083
复制
发表时间：
2013-05
影响因子：
5.8
通讯作者：
Svensson J
中科院分区：
文献类型：
--
作者：
Elbornsson M;Götherström G;Bosæus I;Bengtsson BÅ;Johannsson G;Svensson J
很少有研究确定成人超过5-10年的生长激素替代对身体成分和心血管危险因素的影响。在这项前瞻性、单中心、开放标签的研究中，研究人员对156名垂体功能低下成人（93名男性）的成人GH缺乏症（GHD）患者进行了为期15年的GH替代对身体成分和心血管危险因素的影响。研究开始时的平均年龄为50.5岁（22-74岁）。采用双能x线吸收仪测定体成分。平均初始生长激素剂量为0.55 (s.e.m. 0.03) mg/d， 15年后逐渐降低至0.40 (0.01)mg/d。平均血清IGF1 SDS从基线时的- 1.53（0.10）上升到研究结束时的0.74(0.13)（与基线相比P<0.001）。研究结束时，瘦软组织（LST）比基线水平增加3% （P<0.001）。在治疗的第一年下降了9% （P<0.001与基线相比）后，体脂（BF）开始增加，并在15年后恢复到基线水平。血清总胆固醇和低密度脂蛋白胆固醇水平降低，血清高密度脂蛋白胆固醇水平升高。空腹血糖从基线时的4.4 (0.1)mmol/l增加到研究结束时的4.8 (0.1)mmol/l （P<0.001）。然而，血HbA1c从5.0（0.1）降至4.6 (0.1)% （P<0.001）。在GHD成人中，15年的GH替代导致BF的短暂下降和LST和血脂的持续改善。空腹血糖升高，血糖化血红蛋白降低。
Few studies have determined the effects of more than 5–10 years of GH replacement in adults on body composition and cardiovascular risk factors. In this prospective, single-center, open-label study, the effects of 15 years of GH replacement on body composition and cardiovascular risk factors were determined in 156 hypopituitary adults (93 men) with adult-onset GH deficiency (GHD). Mean age was 50.5 (range 22–74) years at study start. Body composition was measured using dual-energy X-ray absorptiometry. The mean initial GH dose of 0.55 (s.e.m. 0.03) mg/day was gradually lowered to 0.40 (0.01) mg/day after 15 years. The mean serum IGF1 SDS increased from −1.53 (0.10) at baseline to 0.74 (0.13) at study end (P<0.001 vs baseline). Lean soft tissue (LST) increased to 3% above the baseline level at study end (P<0.001). After a 9% decrease during the first year of treatment (P<0.001 vs baseline), body fat (BF) started to increase and had returned to the baseline level after 15 years. Serum levels of total cholesterol and LDL-cholesterol decreased and serum HDL-cholesterol level increased. Fasting plasma glucose increased from 4.4 (0.1) at baseline to 4.8 (0.1) mmol/l at study end (P<0.001). However, blood HbA1c decreased from 5.0 (0.1) to 4.6 (0.1) % (P<0.001). Fifteen-year GH replacement in GHD adults induced a transient decrease in BF and sustained improvements of LST and serum lipid profile. Fasting plasma glucose increased whereas blood HbA1c was reduced.