重组人生长激素替代治疗对体脂含量的影响研究

Study of the impact of rhGH supplementary treatment on lipid metabolism

目的分析重组人生长激素(rhGH)治疗生长激素缺乏症(GHD)后患儿体质量变化的规律及原因;寻找rhGH替代治疗后便捷、灵敏地监测脂代谢变化的指标,了解机体脂代谢变化与rhGH疗效的相关性。方法随机选择完全性生长激素缺乏症(GHD)患儿15例,给予rhGH0.033mg/(kg·d)治疗,疗程6个月。观察用药前后身高(Ht)、生长速度(GV)、身高标准差积分(HtSDS)的变化,评价rhGH的促生长作用;测量治疗前、治疗3个月后、治疗6个月后的体质量(Wt)、体脂含量(Fat%)、体质指数(BMI)、腰臀比(WHR),检测治疗前、治疗6个月后的血脂水平,评价GHD患儿rhGH治疗前、后脂代谢状况。分析rhGH治疗后机体脂代谢变化与rhGH疗效的相关性。结果治疗后患儿Ht、GV、HtSDS改善显著(P<0.01),rhGH促生长作用肯定;治疗后患儿Fat%、血HDL、LDL水平较治疗前显著下降(P<0.05),机体脂代谢得到改善;rhGH治疗3个月与治疗6个月的ΔFat%与ΔGV存在负相关性(r=-0.625,P=0.0096)。结论rhGH治疗GHD后的体质量增长,为非脂肪的增长;体脂含量监测便捷无创,较血脂监测更敏感,有助于了解患儿机体早期脂代谢变化;rhGH治疗后机体体脂含量的改变是影响rhGH疗效的因素之一,具有观测rhGH促生长效率的作用。

Objective To analyze the characteristics and reason of weight change in children with growth hormone deficiency （GHD） after treatment with recombine human growth hormone （rhGH）;to find a rapid,sensitive index of lipid metabolism after treatment with rhGH,and the possible correlation between lipid metabolism and rhGH treatment.Methods Fifteen pediatric patients with complete GHD were select in random.Each of them was treated with rhGH 0.033 mg/（kg·d） for 6 months.（1） To evaluate the role of rhGH in pro-growth by comparing the height （Ht）,growth velocity （GV）,height standard deviation score （HtSDS） of these patients before and after treatment.（2） To evaluate lipid metabolism by comparing weight （Wt）,Fat%,body mass index （BMI） and waist-to-hip ratio （WHR） before and after treatment for 3,6 months,and comparing blood lipid before and after treatment for 6 months as well.（3） To analyze correlation between lipid metabolism and effect of treatment with rhGH.Results After treatment with rhGH,（1） the Ht,GV,HtSDS of these patients were improved significantly （P〈 0.01）,showing the positive role of rhGH in growth;（2） Fat%,blood HDL,LDL were decreased,demonstrating the largely improvement of lipid metabolism;（3） ΔFat% and ΔGV was negatively correlated,correlation coefficient is-0.625 （P=0.009 6） between treatment 3 and 6 months.Conclusions After treatment with rhGH,the increase of non-fat portion contributes to the increase of total weight.Fat% is a rapid,non-invasive index and more sensitive than blood lipid to reflect the early change of lipid metabolism.The change of Fat% after treatment is a potential factor to affect rhGH treatment and is used to access the pro-growth of rhGH in GHD patients.