Growth hormone improves protein catabolism and growth in prepubertal children with HIV infection.
Growth hormone improves protein catabolism and growth in prepubertal children with HIV infection.
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生长激素可改善青春期前感染艾滋病毒儿童的蛋白质分解代谢和生长。
DOI：
10.1111/j.1365-2265.2005.02331.x
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Pavia,Andrew
中科院分区：
文献类型：
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作者：
Hardin,DanaS;Rice,Julie;Doyle,MarilynE;Pavia,Andrew
前言人类免疫缺陷病毒(HIV)感染的儿童存在线性生长不良和体重减轻，过去的成人和儿童研究表明瘦组织块(LTM)的丢失与蛋白质分解代谢的加速有关。我们进行了这项研究，以验证人类重组生长激素会改善HIV感染儿童的线性身高的假设。我们的第二个目标是确定生长激素是否能逆转HIV感染儿童的蛋白质分解代谢。方法我们研究了6名HIV感染儿童(平均年龄9.2岁，Tanner I期，CD4计数110-292,000，2名女孩，4名男孩)。使用稳定同位素1-[13C]亮氨酸进行蛋白质周转的测量。采用双能X线骨密度仪(DXA)扫描测量体成分，测定LTM。检测病毒载量和IGF-1水平。结果这些儿童的基线生长速度仅为3.9亿cm/年。生长6个月后，生长速度提高到7.9 cm/年。蛋白质分解代谢，以空腹状态下的亮氨酸出现率(Ra)表示，在基线时很高，但在GH治疗6个月后显著下降。所有受试者的瘦组织质量均显著改善。在生长激素治疗期间，任何受试者的病毒负荷均未明显增加。结论生长激素可改善HIV感染儿童的身高和体重，减少蛋白质分解代谢，但不会对病毒负荷产生负面影响。
IntroductionPoor linear growth and weight loss are well documented in children with human immunodeficiency virus (HIV) infection and past studies in adults and children have reported that loss of lean tissue mass (LTM) associated with accelerated rates of protein catabolism. We undertook this study to test the hypothesis that human recombinant GH would improve linear height in HIV‐infected children. Our second goal was to determine if GH could reverse protein catabolism in HIV‐infected children.MethodsWe studied six HIV‐infected children (mean age 9·2 years, Tanner stage I, CD4 counts 110 000–292 000, two girls, four boys). Measures of protein turnover were conducted using the stable isotope 1‐[13C] leucine. Body composition was measured by dual X‐ray absorptiometry (DXA) scan for determination of LTM. Viral burden and IGF‐1 levels were measured. Studies were conducted at baseline and 6 months.ResultsThe baseline growth velocity of these children was only 3·9 cm/year. After 6 months of GH, growth velocity increased to 7·9 cm/year. Protein catabolism, represented as leucine rate of appearance (Ra) in the fasted state, was high at baseline, but decreased significantly after 6 months of GH therapy. Lean tissue mass significantly improved in all subjects. Viral burden did not increase significantly in any subject during GH therapy.ConclusionThese results suggest that GH improves height and weight and reduces protein catabolism in HIV‐infected children without negative effect on viral burden.