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【JCEM】肢端肥大症治愈后继发GHD采用GH替代治疗
Context: The effects of GH replacement in GH-deficient (GHD) adults previously treated for acromegaly are not well known.
Objective, Design, and Patients: In this single-center, open-labeled, prospective study, 10 consecutive GHD adults with cured acromegaly (A group) and 10 matched GHD adults with previous nonfunctioning hypopituitary disease (NF group) were included. Comparisons were made at baseline and in the responses in body composition, muscle strength, bone mass, and metabolic indices during 2 yr of GH replacement.
Results: At baseline, upper leg local muscle endurance and serum low-density lipoprotein-cholesterol concentration were more impaired in the A group. The A group contained three patients with hypertension, one with diabetes mellitus type 2, and one with hyperlipidemia. The NF group had only one patient with hypertension. There were no significant between-group differences in the responses to the GH therapy. Body composition and serum lipid pattern improved in both groups without any deterioration of glucose homeostasis. At study end, no difference remained between the two groups in any variable. During the 2-yr treatment, one patient had a myocardial infarction and two had cerebral infarctions in the A group, whereas no vascular event occurred in the NF group.
Conclusions: GHD patients with previous acromegaly have an impaired cardiovascular risk profile and decreased local muscle endurance as compared with other GHD patients. Two-year GH replacement eliminated these differences, but vascular events occurred more frequently in the A group. Therefore, GHD patients with cured acromegaly will benefit from GH replacement, but careful monitoring of cardiovascular status is needed.
2531.pdf (134.65k) Baseline Characteristics and the Effects of Two Years of Growth Hormone (GH) Replacement Therapy in Adults with GH Deficiency Previously Treated for Acromegaly
在原先肢端肥大治愈患者继发生长激素缺乏的患者中使用生长激素替代治疗2年的基线特征及治疗影响
Context: The effects of GH replacement in GH-deficient (GHD) adults previously treated for acromegaly are not well known.
内容：在原先肢端肥大症治愈继发生长激素缺乏的患者中使用生长激素替代治疗的影响尚不明确。
Objective, Design, and Patients: In this single-center, open-labeled, prospective study, 10 consecutive GHD adults with cured acromegaly (A group) and 10 matched GHD adults with previous nonfunctioning hypopituitary disease (NF group) were included. Comparisons were made at baseline and in the responses in body composition, muscle strength, bone mass, and metabolic indices during 2 yr of GH replacement.
目的，设计，及入选患者：这是一个单中心的，开放的，前瞻性研究，研究中分为A组和NF组。其中A组的入选患者是10名原先有肢端肥大已经治愈继发生长激素缺乏的成年患者，NF组是10名原先有非功能性低垂体后叶素疾病的患者。两组间的比较把包括基线水平及治疗2年后的身体组成，肌肉强度，骨密度，代谢指数。
Results: At baseline, upper leg local muscle endurance and serum low-density lipoprotein-cholesterol concentration were more impaired in the A group. The A group contained three patients with hypertension, one with diabetes mellitus type 2, and one with hyperlipidemia. The NF group had only one patient with hypertension. There were no significant between-group differences in the responses to the GH therapy. Body composition and serum lipid pattern improved in both groups without any deterioration of glucose homeostasis. At study end, no difference remained between the two groups in any variable. During the 2-yr treatment, one patient had a myocardial infarction and two had cerebral infarctions in the A group, whereas no vascular event occurred in the NF group.
结果：在基线水平（没有治疗前），肢端肥大症组的大腿肌肉的韧性受损，血清低密度脂蛋白的浓度更高。在肢端肥大症组，3名患者患有高血压，1名患者是2型糖尿病患者，1名患者患有高脂血症。在无功能低垂体后叶素组，仅有1名患者有高血压。两组使用生长激素治疗的反应没有统计学差异。治疗后，两组的身体组成和血脂浓度都明显好转，没有糖耐量损伤的恶化。在研究结束的时候，这些数据两组间没有什么统计学的差异。在替代治疗的2年间，在肢端肥大症组有1名心肌梗死，2名脑梗死出现，而在NF组，没有出现血管事件。
Conclusions: GHD patients with previous acromegaly have an impaired cardiovascular risk profile and decreased local muscle endurance as compared with other GHD patients. Two-year GH replacement eliminated these differences, but vascular events occurred more frequently in the A group. Therefore, GHD patients with cured acromegaly will benefit from GH replacement, but careful monitoring of cardiovascular status is needed.
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作者:admin@医学,生命科学 2011-08-24 17:19
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