重组生长激素对肾病综合征患者血脂代谢的影响

Effects of recombinant human growth hormone on serum lipid in nephrotic patients

目的观察基因重组生长激素(rhGH)对肾病综合征(NS)患者血脂TG、TC、HDL、LDL,与IGF-1和IGFBP-3的作用。方法原发性NS患者100例,随机分为2组:治疗组50例,在常规治疗的基础上加上rhGH治疗2周;对照组50例用常规治疗。另选健康人10名作为正常组。以放射免疫法测血清IGF-1和IGFBP-3水平,全自动生化仪检测血清TG、TC、HDL和LDL水平。结果与正常组相比,治疗组和对照组治疗前血清IGF-1、IGFBP-3水平均明显降低,两组在治疗前、后血清TC、TG、HDL和LDL水平均明显升高,差异具有统计学意义(P<0.01)。与治疗前相比,治疗组rhGH治疗2周后血清IGF-1和IGFBP-3水平显著上升,TC和LDL水平显著下降,TG和HDL无明显变化;而对照组的各项检测指标在治疗前后均无统计学差异。结论IGF-1和IGFBP-3参与了肾病综合征血脂代谢紊乱的发生,短期小剂量rhGH可以通过提高IGF-1、IGFBP-3水平而改善患者的血脂代谢。

Objective To investigate the effects of recombinant human growth hormone （rhGH） on serum total cholesterol （TC）, triglycerides （TG）, high density lipoprotein-cholesterol （HDL） ,low density lipoprotein-cholesterol （LDL）, insulin-like growth factor-1 （IGF-1） and insulin-like growth factor binding protein 3 （IGFBP-3） in nephrotic patients. Methods One hundred nephrotic patients were randomly divided into conventional group （ n = 50） and rhGH-treated group （ n = 50）. Ten normal subjects were chosen as normal group. IGF-1 and IGFBP-3 concentrations in serum were measured with RIA. TC, TG, HDL and LDL levels in serum were measured with automatic biochemistry appliance. Results Serum levels of IGF-1 and IGFBP-3 in conventional group and rhGH-treated group decreased compared with normal group. Serum TC, TG, HDL and LDL in two treated groups were higher than those in normal group before and after the treatment. Serum levels of IGF-1 and IGFBP-3 in rhGH-treated group significantly increased after the treatment for 2 weeks, while serum TC and LDL levels decreased significantly. There was no statistical difference between two groups in serum TG and HDL levels before and after the treatment. Conclusion The dyslipidemia in nephrotic patients might be caused by the decrease of IGF-1/ IGFBP-3. rhGH could improve the serum lipid by upregnlating the expression of IGF-1/IGFBP-3 in serum.