成人生长激素缺乏症患者骨保护素水平的研究

Osteoprotegerin Levels in Adult Growth Hormone Deficiency Patients

目的探讨成人生长激素缺乏症(AGHD)患者与健康成人血浆骨保护素(OPG)水平及其与人体测量指标、糖脂代谢指标及超敏C反应蛋白(hs-CRP)的关系。方法选择重庆医科大学附属第一医院2009年6月—2012年6月复诊的垂体腺瘤术后患者37例(术后>6个月)和席汉综合征患者8例,共45例为AGHD组,另选择性别、年龄与AGHD组匹配的40例健康体检者为对照组,测量身高、体质量、血压、腰围、臀围,测定脂肪率,计算体质指数(BMI)、腰臀比。测定总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、hs-CRP、空腹血糖(FPG)、空腹胰岛素(FINS)、OPG水平,计算胰岛素抵抗指数(HOMA-IR)及β细胞胰岛素分泌指数(HOMA-β)。结果 AGHD组腰臀比及hs-CRP、OPG水平高于对照组,FPG、HDL-C水平低于对照组(P<0.05);两组其他指标比较,差异均无统计学意义(P>0.05)。OPG与hs-CRP呈正相关(r=0.353,P<0.05),与HDL-C呈负相关(r=-0.245,P<0.05)。以OPG为应变量,以hs-CRP、HDL-C为自变量,做多元线性回归分析结果显示,HDL-C进入回归方程,Y=158.144+4.894×X HDL-C(R2=0.126,P<0.05)。结论 AGHD患者血浆OPG水平升高,并与HDL-C水平相关。提示在AGHD患者中血浆OPG可能在AGHD患者心血管疾病的发生、发展中起到重要作用。

Objective To compare the plasma osteoprotegerin （OPG） levels between adult growth hormone deficiency （AGHD） patients and healthy adults, to explore its relationship to anthropometric measurements, glucose and lipid metabolism, blood pressure, free fatty acid, high sensitive C -reactive protein （hs -CRP） and others. Methods A total of 37 postopera- tive pituitary adenoma patients （ 〉 6 months after operation） and 8 Sheehan Syndrome patients were enrolled into AGHD group, 40 healthy subjects matching AGHD group in gender and age into control group. Height, body mass, blood pressure, waist circ- umference, hip circumference, fat percentage were measured, body mass index （BMI） and waist - hip ratio calculated, the levels of total cholesterol （ TC ）, triglyceride （ TG）, high density lipoprotein cholesterol （ HDL - C）, low density lipoprotein cholesterol （LDL- C）, hs- CRP, fasting plasma glucose （FPG）, fasting insulin （FINS）, OPG determined, and insulin resistance index （ HOMA - IR） , 13 cell insulin secretion index （ HOMA - β） calculated. Results The waist - hip ratio, OPG level were higher in AGHD group than control group, FPG, HDL - C lower （P 〈 0. 05 ）, but there was not significant difference in other indicators （P 〉 0. 05）. OPG was positively correlated with hs - CRP （r = 0. 353, P 〈0. 05 ）, negatively with HDL - C （r = -0. 245, P 〈0. 05）. OPG was taken as dependent variable, hs - CRP, HDL - C as independent variable to make multi- ple linear regression analysis, HDL - C entered into the regression equation, Y = 158. 144 ＋ 4. 894 x XSDL- C （R2 = 0. 126, P 〈 0. 05）. Conclusion OPG, elevated in AGHD patients, is correlated with HDL - C, suggesting that plasma OPG might play an important role in occurrence and development of cardiovascular diseases in AGHD patients.