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Hormonal stress responses of growth hormone and insulin-like growth factor-I in highly resistance trained women and men 生长激素和胰岛素样生长因子- 1在高抵抗训练的男女中的激素应激反应
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-08-01 DOI: 10.1016/j.ghir.2021.101407
Disa L. Hatfield , William J. Kraemer , Jeff S. Volek , Bradley C. Nindl , Lydia K. Caldwell , Jakob L. Vingren , Robert U. Newton , Keijo Häkkinen , Elaine C. Lee , Carl M. Maresh , Wesley C. Hymer

The purpose of this study was to examine the responses of growth hormone (GH) and insulin-like growth factor-I (IGFI) to intense heavy resistance exercise in highly trained men and women to determine what sex-dependent responses may exist. Subjects were highly resistance trained men (N = 8, Mean ± SD; age, yrs., 21 ± 1, height, cm, 175.3 ± 6.7, body mass, kg, 87.0 ± 18.5, % body fat, 15.2 ± 5.4, squat X body mass, 2.1 ± 0.4; and women (N = 7; Mean ± SD, age, yrs. 24 ± 5, height, cm 164.6 ± 6.7, body mass, kg 76.4 ± 8.8, % body fat, 26.9 ± 5.3, squat X body mass, 1.7 ± 0.6). An acute resistance exercise test protocol (ARET) consisted of 6 sets of 10 repetitions at 80% of the 1 RM with 2 min rest between sets was used as the stressor. Blood samples were obtained pre-exercise, after 3 sets, and then immediately after exercise (IP), 5, 15, 30, and 70 min post-exercise for determination of blood lactate (HLa), and plasma glucose, insulin, cortisol, and GH. Determination of plasma concentrations of IGFI, IGF binding proteins 1, 2, and 3 along with molecular weight isoform factions were determined at pre, IP and 70 min. GH significantly (P ≤ 0.05) increased at all time points with resting concentrations significantly higher in women. Significant increases were observed for HLa, glucose, insulin, and cortisol with exercise and into recovery with no sex-dependent observations. Women showed IGF-I values that were higher than men at all times points with both seeing exercise increases. IGFBP-1 and 2 showed increase with exercise with no sex-dependent differences. IGFBP-3 concentrations were higher in women at all-time points with no exercise induced changes. Both women and men saw an exercise induced increase with significantly higher values in GH in only the mid-range (30-60 kD) isoform.  Only women saw an exercise induced increase with significantly higher values for IGF fractions only in the mid-range (30–60 kD) isoform, which were significantly greater than the men at the IP and 70 min post-exercise time points. In conclusion, the salient findings of this investigation were that in highly resistance trained men and women, sexual dimorphisms exist but appear different from our prior work in untrained men and women and appear to support a sexual dimorphism related to compensatory aspects in women for anabolic mediating mechanisms in cellular interactions.

本研究的目的是检查在高强度训练的男性和女性中生长激素(GH)和胰岛素样生长因子- 1 (IGFI)对高强度大阻力运动的反应,以确定可能存在的性别依赖性反应。受试者为高度抵抗训练的男性(N = 8, Mean±SD;年龄、年。21±1、身高厘米,175.3±6.7,体重,公斤,87.0±18.5,%身体脂肪,15.2±5.4,蹲X体重,2.1±0.4;女性(N = 7;平均±SD,年龄,年。24±5、身高厘米164.6±6.7,体重,公斤76.4±8.8,%身体脂肪,26.9±5.3,蹲X体重,1.7±0.6)。急性阻力运动测试方案(ARET)包括6组,每组10次重复,每次1 RM的80%,每组之间休息2分钟作为应激源。分别在运动前、运动3组后、运动后立即(IP)、运动后5、15、30和70分钟采集血样,测定血乳酸(HLa)、血浆葡萄糖、胰岛素、皮质醇和生长激素。分别在注射前、注射后和注射后70分钟测定血浆中IGFI、IGF结合蛋白1、2和3的浓度以及分子量同型异构体的含量。GH在所有时间点均显著升高(P≤0.05),女性静息时GH浓度显著升高。HLa、葡萄糖、胰岛素和皮质醇随着运动和恢复而显著增加,没有性别依赖的观察。女性的IGF-I值在所有时间点都高于男性,两者都看到锻炼的增加。IGFBP-1和2随运动而增加,无性别差异。在没有运动引起的变化的情况下,女性的IGFBP-3浓度在所有时间点都更高。在运动诱导下,女性和男性的生长激素仅在中程(30-60 kD)亚型中显著升高。只有女性看到运动引起的IGF分数增加,只有在中程(30-60 kD)亚型显著升高,在IP和运动后70分钟时间点显著高于男性。总之,这项研究的显著发现是,在高度抵抗训练的男性和女性中,两性异形存在,但与我们之前在未经训练的男性和女性中的研究不同,并且似乎支持与女性在细胞相互作用中合成代谢介导机制的代偿方面相关的两性异形。
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引用次数: 7
Association between insulin-like growth factor 1 and pancreatic volume in type 1 and type 2 diabetes: cross-sectional study of a Japanese population 1型和2型糖尿病患者胰岛素样生长因子1与胰腺体积的关系:日本人群的横断面研究
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-08-01 DOI: 10.1016/j.ghir.2021.101396
Tomoyasu Fukui , Ayako Fukase , Hiroto Sasamori , Makoto Ohara , Yusaku Mori , Michishige Terasaki , Munenori Hiromura , Hideki Kushima , Tetsuro Kobayashi , Sho-ichi Yamagishi

Aims/hypothesis

Although IGF-1 is known to promote organ growth, including exocrine pancreas, the association between plasma IGF-1 levels and pancreatic size remains unclear in diabetic patients.

Methods

This cross-sectional study was designed to investigate the correlations among pancreatic volume (PV) based on computed tomography, IGF-1 levels, age- and sex-adjusted IGF-1 levels (IGF-1 Z-score), and C-peptide levels in patients with type 1 diabetes (T1D) (n = 51) and type 2 diabetes (T2D) (n = 104) in a Japanese population.

Results

PV was significantly correlated with body weight (BW) in both types of diabetes. PV adjusted for BW (PV/BW), IGF-1 Z-score and C-peptide levels were significantly lower in patients with T1D than T2D. There was a significant positive correlation between C-peptide levels and PV/BW in both subtypes of diabetes. IGF-1 Z-scores were significantly correlated with PV/BW in patients with T1D (r = 0.37, P = 0.007), but not T2D. Although IGF-1 Z-scores were not correlated with age, age of disease onset, disease duration, HbA1c, or C-peptide levels in both types of diabetes, a multivariable liner regression analysis revealed that IGF-1 Z-score and C-peptide levels were independent correlates of PV/BW in T1D patients, while C-peptide levels were a sole correlate in T2D.

Conclusions/interpretation

Decreased IGF-1 levels might be one causal factor for smaller pancreas in patients with T1D.

目的/假设虽然已知IGF-1促进器官生长,包括外分泌胰腺,但糖尿病患者血浆IGF-1水平与胰腺大小之间的关系尚不清楚。方法本横断面研究旨在探讨日本人群中1型糖尿病(T1D) (n = 51)和2型糖尿病(T2D) (n = 104)患者胰腺体积(PV)、IGF-1水平、年龄和性别调整的IGF-1水平(IGF-1 Z-score)和c肽水平之间的相关性。结果两型糖尿病患者的spv均与体重(BW)显著相关。T1D患者经体重调整后的PV (PV/BW)、IGF-1 Z-score和c肽水平均显著低于T2D患者。在两种糖尿病亚型中,c肽水平与PV/BW呈显著正相关。T1D患者IGF-1 z评分与PV/BW显著相关(r = 0.37, P = 0.007),而T2D患者无显著相关。虽然IGF-1 z -评分与两种糖尿病患者的年龄、发病年龄、病程、HbA1c或c肽水平无关,但多变量线性回归分析显示,IGF-1 z -评分和c肽水平是T1D患者PV/BW的独立相关因素,而c肽水平是T2D患者的唯一相关因素。结论/解释IGF-1水平降低可能是T1D患者胰腺变小的一个原因。
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引用次数: 2
Economic and clinical burden of comorbidities among patients with acromegaly 肢端肥大症患者合并症的经济和临床负担
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-08-01 DOI: 10.1016/j.ghir.2021.101389
Melanie D. Whittington , Kathryn A. Munoz , John D. Whalen , Antonio Ribeiro-Oliveira , Jonathan D. Campbell

Objective

Acromegaly is a rare, pituitary hormonal disorder that requires improved awareness worldwide. The objective of this analysis was to quantify the clinical and economic burden of comorbidities for patients with acromegaly and examine the influence of biochemical control on these outcomes.

Study design

Markov cohort decision analytic model consisting of two states, including alive (with and without comorbidity) and dead.

Methods

A cohort of patients with acromegaly who had achieved biochemical control, a cohort of patients with acromegaly who had not achieved biochemical control, and a cohort of individuals from the general US population were tracked over a lifetime time horizon. The model tracked the proportion of the alive population that had each comorbidity based on age, sex, presence of acromegaly, and biochemical control status. The proportion of patients with each acromegaly-associated comorbidity were assigned comorbidity-associated costs, disutilities, and increased risk of mortality.

Results

Compared with the general population, controlled acromegaly resulted in $192,000 additional comorbidity-related costs, 0.7 fewer years of life, 2.9 fewer quality-adjusted life years, and 1.1 more comorbidities across the remaining lifespan. Compared with the general population, uncontrolled acromegaly resulted in $285,000 additional comorbidity-related costs, 0.9 fewer years of life, 4.2 fewer quality-adjusted life years, and 1.6 more comorbidities across the remaining lifespan.

Conclusions

Achieving biochemical control is associated with improvements in cost, quality of life, and mortality, albeit not to the level of the general population. A multimodal treatment strategy including biochemical control and management of comorbidities is necessary to improve patient outcomes.

肢端肥大症是一种罕见的垂体激素紊乱,需要提高全世界的认识。本分析的目的是量化肢端肥大症患者合并症的临床和经济负担,并检查生化控制对这些结果的影响。研究设计马尔可夫队列决策分析模型由两种状态组成,包括生存(有或无合并症)和死亡。方法对一组生化控制的肢端肥大症患者、一组未生化控制的肢端肥大症患者和一组来自美国普通人群的个体进行终身追踪。该模型根据年龄、性别、肢端肥大症的存在和生化控制状态跟踪了患有每种合并症的活人群的比例。每个肢端肥大症相关合并症患者的比例被分配为合并症相关的费用、效用不足和死亡风险增加。结果与普通人群相比,控制性肢端肥大症患者的共病相关费用增加19.2万美元,寿命减少0.7年,质量调整寿命减少2.9年,剩余寿命中共病增加1.1年。与一般人群相比,未受控制的肢端肥大症导致额外285,000美元的合并症相关费用,0.9年的寿命减少,4.2年的质量调整寿命减少,1.6年的合并症增加。结论:实现生化控制与成本、生活质量和死亡率的改善有关,尽管与一般人群的水平不同。包括生化控制和合并症管理在内的多模式治疗策略对于改善患者预后是必要的。
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引用次数: 8
Differential effects of androgens and estrogens over cellular GH sensitivity in HEPG2 cells 雄激素和雌激素对HEPG2细胞生长激素敏感性的不同影响
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101390
Paula Ocaranza, Germán Íñiguez, M. Cecilia Johnson, Fernando Cassorla

Testosterone and estrogen concentrations progressively increase during puberty, and in association with growth hormone (GH), lead to the increase in height velocity known as the pubertal growth spurt. Very limited information is available however, regarding the possible effects of sex steroids over GH cellular sensitivity.

Objective

To investigate the effects of different concentrations of testosterone, estradiol and dihydrotestosterone over the GH intracellular signaling pathway.

Methods

We evaluated the effects of these sex steroids on the nuclear phosphorylation of STAT5b and IGF-1 expression, in HEPG2 human hepatoma cells. In addition, we studied whether Tamoxifen (TAM), can modulate these effects.

Results

The highest concentration of T tested (10 ng/mL) co-incubated with a fixed concentration of GH (40 ng/mL) increased nuclear STAT5b phosphorylation compared with GH alone (1.34 ± 0.2 vs 0.6 ± 0.09 AU; *p < 0.05), as well as IGF-1 expression (0.6 ± 0.03 vs 0.32 ± 0.05 AU; *p < 0.05). This effect was not observed with lower concentrations of T tested (1 and 5 ng/mL). A similar increase in nuclear STAT5b phosphorylation was observed with the lowest concentration of E2 tested (20 pg/mL), co-incubated with the same fixed concentration of GH (3.6 ± 0.5 vs 1.28 ± 0.33 AU; *p < 0.05). This effect was also associated with an increase in IGF-1 expression (0.73 ± 0.02 vs 0.39 ± 0.04 AU; *p < 0.05). These results were not observed with higher concentrations of E2 tested (75 and 200 pg/mL). DHT at concentrations of 0.1, 0.25 and 0.5 ng/mL, co-stimulated with GH, did not change cytoplasmic STAT5b phosphorylation, nuclear STAT5b or IGF-1 expression. In addition, the co-incubation of TAM with the highest concentration of T tested (10 ng/mL) and GH (40 ng/mL) did not change cytoplasmic, nuclear pSTAT5 levels or IGF-1 expression.

Conclusions

T and E2 potentiate the GH signaling pathway in a concentration-dependent fashion. The observation that the non-aromatizable androgen dihydrotestosterone does not stimulate this pathway, and that the effects of T are blocked with TAM, suggests that the effects of T over the GH signaling pathway appear to be mediated by estrogen.

睾酮和雌激素浓度在青春期逐渐增加,并与生长激素(GH)相关,导致身高速度的增加,即青春期生长突增。然而,关于性类固醇对生长激素细胞敏感性的可能影响的信息非常有限。目的探讨不同浓度睾酮、雌二醇和二氢睾酮对生长激素细胞内信号通路的影响。方法观察这些性类固醇对HEPG2人肝癌细胞STAT5b核磷酸化和IGF-1表达的影响。此外,我们还研究了他莫昔芬(TAM)是否可以调节这些作用。结果最高浓度的T (10 ng/mL)与固定浓度的生长激素(40 ng/mL)共孵育,与生长激素单独孵育相比,细胞核STAT5b磷酸化增加(1.34±0.2 AU vs 0.6±0.09 AU;* p & lt;0.05),以及IGF-1表达(0.6±0.03 vs 0.32±0.05 AU;* p & lt;0.05)。较低浓度的T(1和5 ng/mL)没有观察到这种效应。最低浓度的E2 (20 pg/mL)与相同固定浓度的GH共孵育(3.6±0.5 AU vs 1.28±0.33 AU)时,细胞核STAT5b磷酸化也有类似的增加;* p & lt;0.05)。这种效应还与IGF-1表达的增加有关(0.73±0.02 AU vs 0.39±0.04 AU;* p & lt;0.05)。当E2浓度较高(75和200 pg/mL)时,没有观察到这些结果。与GH共刺激浓度为0.1、0.25和0.5 ng/mL的DHT未改变细胞质STAT5b磷酸化、细胞核STAT5b或IGF-1的表达。此外,TAM与最高浓度T (10 ng/mL)和生长激素(40 ng/mL)共孵育未改变细胞质、细胞核pSTAT5水平或IGF-1表达。结论st和E2以浓度依赖性的方式增强GH信号通路。观察到非芳香化雄激素双氢睾酮不会刺激这一途径,并且T的作用被TAM阻断,这表明T对生长激素信号通路的影响似乎是由雌激素介导的。
{"title":"Differential effects of androgens and estrogens over cellular GH sensitivity in HEPG2 cells","authors":"Paula Ocaranza,&nbsp;Germán Íñiguez,&nbsp;M. Cecilia Johnson,&nbsp;Fernando Cassorla","doi":"10.1016/j.ghir.2021.101390","DOIUrl":"10.1016/j.ghir.2021.101390","url":null,"abstract":"<div><p>Testosterone and estrogen concentrations progressively increase during puberty, and in association with growth hormone (GH), lead to the increase in height velocity known as the pubertal growth spurt. Very limited information is available however, regarding the possible effects of sex steroids over GH cellular sensitivity.</p></div><div><h3>Objective</h3><p>To investigate the effects of different concentrations of testosterone, estradiol and dihydrotestosterone over the GH intracellular signaling pathway.</p></div><div><h3>Methods</h3><p>We evaluated the effects of these sex steroids on the nuclear phosphorylation of STAT5b and <em>IGF-1</em> expression, in HEPG2 human hepatoma cells. In addition, we studied whether Tamoxifen (TAM), can modulate these effects.</p></div><div><h3>Results</h3><p>The highest concentration of T tested (10 ng/mL) co-incubated with a fixed concentration of GH (40 ng/mL) increased nuclear STAT5b phosphorylation compared with GH alone (1.34 ± 0.2 vs 0.6 ± 0.09 AU; *<em>p</em> &lt; 0.05), as well as <em>IGF-1</em> expression (0.6 ± 0.03 vs 0.32 ± 0.05 AU; *p &lt; 0.05). This effect was not observed with lower concentrations of T tested (1 and 5 ng/mL). A similar increase in nuclear STAT5b phosphorylation was observed with the lowest concentration of E<sub>2</sub> tested (20 pg/mL), co-incubated with the same fixed concentration of GH (3.6 ± 0.5 vs 1.28 ± 0.33 AU; *<em>p</em> &lt; 0.05). This effect was also associated with an increase in <em>IGF-1</em> expression (0.73 ± 0.02 vs 0.39 ± 0.04 AU; *<em>p</em> &lt; 0.05). These results were not observed with higher concentrations of E<sub>2</sub> tested (75 and 200 pg/mL). DHT at concentrations of 0.1, 0.25 and 0.5 ng/mL, co-stimulated with GH, did not change cytoplasmic STAT5b phosphorylation, nuclear STAT5b or <em>IGF-1</em> expression. In addition, the co-incubation of TAM with the highest concentration of T tested (10 ng/mL) and GH (40 ng/mL) did not change cytoplasmic, nuclear pSTAT5 levels or <em>IGF-1</em> expression.</p></div><div><h3>Conclusions</h3><p>T and E<sub>2</sub> potentiate the GH signaling pathway in a concentration-dependent fashion. The observation that the non-aromatizable androgen dihydrotestosterone does not stimulate this pathway, and that the effects of T are blocked with TAM, suggests that the effects of T over the GH signaling pathway appear to be mediated by estrogen.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38970946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulse wave velocity is decreased in acromegaly compared to non-acromegaly study participants with similar cardiovascular risk profile 与心血管风险相似的非肢端肥大患者相比,肢端肥大患者的脉搏波速度降低
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101395
Irina Filchenko , Lyudmila Korostovtseva , Mikhail Bochkarev , Maria Boyarinova , Asiyat Alieva , Oxana Rotar , Yuri Sviryaev , Uliana Tsoi , Elena Grineva

Objective

Acromegaly patients were reported to have an increased arterial stiffness that could contribute to the frequent cardiovascular complications in this population. The chronic excess of GH and IGF-1 may lead to arterial stiffening via different mechanisms, including hypertension, impaired glucose tolerance and dyslipidemia, however, it is not known whether the activation of GH/IGF-1 axis might influence arterial stiffening independently of cardiovascular risk factors. The objective of this prospective case-control study was to compare arterial stiffness assessed with pulse-wave velocity (PWV) in acromegaly versus non-acromegaly group with similar cardiovascular risk profile.

Design

This prospective case-control study included 27 patients with active acromegaly, who underwent the assessment of clinical, physiological, biochemical parameters and the evaluation of PWV with applanation tonometry. We used “The epidemiology of cardiovascular disease in different regions of the Russian Federation” study database (n = 522) to establish a non-acromegaly control group with similar cardiovascular risk profile (n = 54). Non-acromegaly control participants underwent the same assessment as acromegaly patients except for the measurement of serum GH and IGF-1 levels. We compared PWV in acromegaly patients to the general non-acromegaly cohort and its subset, matched with acromegaly patients for cardiovascular risk factors. We also investigated the associations of PWV with clinical, physiological and biochemical parameters in acromegaly and non-acromegaly group using correlation and regression analysis with adjustment for age and sex.

Results

Acromegaly patients had lower PWV (6.70 (5.75–7.65) m/s) compared to unmatched non-acromegaly control cohort (7.50 (6.70–8.57) m/s, p = 0.01) and to the non-acromegaly control group matched for cardiovascular risk factors (7.45 (6.73–8.60), p < 0.01). In non-acromegaly control group PWV was associated with BMI (ρ = 0.40, p < 0.01; β = 0.09, p < 0.01), obesity (r = 0.46, p < 0.01; β = 1.36, p < 0.01), systolic blood pressure (ρ = 0.60, p < 0.01; β = 0.05, p < 0.01), diastolic blood pressure (ρ = 0.62, p < 0.01; β = 0.07, p < 0.01), triglycerides (ρ = 0.55, p < 0.01; β = 0.58, p = 0.04), glucose (ρ = 0.54, p < 0.01; β = 0.70, p < 0.01) and diabetes (r = 0.40, p < 0.01; β = 1.10, p = 0.03), while in acromegaly group PWV was associated with IGF-1 expressed in mcg/ml (ρ = −0.49, p ≤0.01; β = −0.002, p ≤0.01) and in percentage of the upper limit of the normal (ρ = −0.47, p = 0.01; β = −0.005, p ≤0.01) as well as with diu

据报道,肢端肥大症患者动脉僵硬度增加,这可能导致该人群频繁出现心血管并发症。生长激素和IGF-1的慢性过量可能通过不同的机制导致动脉硬化,包括高血压、糖耐量受损和血脂异常,然而,目前尚不清楚生长激素/IGF-1轴的激活是否可能独立于心血管危险因素影响动脉硬化。这项前瞻性病例对照研究的目的是比较具有相似心血管风险特征的肢端肥大症和非肢端肥大症患者用脉搏波速度(PWV)评估的动脉硬度。设计本前瞻性病例对照研究纳入27例活动性肢端肥大症患者,采用平压血压计评估临床、生理、生化参数和PWV。我们使用“俄罗斯联邦不同地区心血管疾病流行病学”研究数据库(n = 522)建立具有相似心血管风险概况的非肢端肥大症对照组(n = 54)。非肢端肥大症对照组接受与肢端肥大症患者相同的评估,除了测量血清GH和IGF-1水平。我们将肢端肥大症患者的PWV与一般非肢端肥大症队列及其亚组进行了比较,并与肢端肥大症患者的心血管危险因素进行了匹配。我们还研究了肢端肥大症和非肢端肥大症患者的PWV与临床、生理生化参数的关系,并进行了年龄和性别校正的相关和回归分析。结果肢端肥大症患者的PWV (6.70 (5.75 ~ 7.65) m/s)低于未匹配的非肢端肥大症对照组(7.50 (6.70 ~ 8.57)m/s, p = 0.01),心血管危险因素匹配的非肢端肥大症对照组(7.45 (6.73 ~ 8.60),p <0.01)。非肢端肥大症对照组PWV与BMI相关(ρ = 0.40, p <0.01;β = 0.09, p <0.01),肥胖(r = 0.46, p <0.01;β = 1.36, p <0.01),收缩压(ρ = 0.60, p <0.01;β = 0.05, p <0.01),舒张压(ρ = 0.62, p <0.01;β = 0.07, p <0.01),甘油三酯(ρ = 0.55, p <0.01;β = 0.58, p = 0.04),葡萄糖(ρ = 0.54, p <0.01;β = 0.70, p <0.01)和糖尿病(r = 0.40, p <0.01;β = 1.10, p = 0.03),肢端肥大症组PWV与IGF-1 mcg/ml表达相关(ρ = - 0.49, p≤0.01;β = - 0.002, p≤0.01),占正常值上限的百分比(ρ = - 0.47, p = 0.01;β=−0.005,p≤0.01)以及利尿剂治疗(β=−1.17,p = 0.03)。结论:肢端肥大症患者的spwv与心血管风险相似的非肢端肥大症对照组相比有所降低。未来的研究需要探索GH/IGF-1轴在动脉壁特性调节中的作用,以及PWV作为肢端肥大症心血管并发症预后指标的可靠性。
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引用次数: 1
Impact of short stature on quality of life: A systematic literature review 身材矮小对生活质量的影响:系统的文献综述
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101392
Philippe Backeljauw , Marco Cappa , Wieland Kiess , Lisa Law , Charlotte Cookson , Caroline Sert , John Whalen , Mehul T. Dattani

Objective

We sought to obtain a better understanding of the burden of short stature using a systematic literature review.

Methods

Studies of the burden of short stature, of any cause in adults and children, were searched using Embase, MEDLINE and Cochrane databases in April 2020, capturing publications from 2008 onwards. Case series and populations with adult-onset growth hormone deficiency (GHD) were excluded.

Results

Of 1684 publications identified, 41 studies (33 in children, 8 in adults) were included. All studies assessed human burden. Most study populations in children included short stature due to GHD, idiopathic short stature (ISS) and short stature after being born small for gestational age (SGA). In these populations, four studies showed that quality of life (QoL) in children with short stature was significantly worse than in children with normal stature. A significant association between QoL and short stature was observed in children with chronic kidney disease (CKD) (3 studies), achondroplasia (1 study) and transfusion-dependent β-thalassaemia (1 study), and in samples with mixed causes of short stature (3 studies). Three studies (one in GHD/ISS/SGA and two in CKD) found no significant association between short stature and QoL, and several studies did not report statistical significance. Approximately half of adult studies showed that QoL was reduced with short stature, and the other half showed no association. Two studies, one in adults with Prader–Willi syndrome and one in children with GHD, suggested a potential association between short stature and poorer cognitive outcomes. Three studies demonstrated an increased caregiver burden in parents of children with short stature.

Conclusions

Evidence suggests that, compared with those with normal stature, children and adults with short stature of any cause may experience poorer QoL. Further research could extend our understanding of the human burden in this field.

目的通过系统的文献回顾,我们试图更好地了解矮小的负担。方法于2020年4月使用Embase、MEDLINE和Cochrane数据库检索成人和儿童中任何原因的矮小负担的研究,获取2008年以来的出版物。排除了成年性生长激素缺乏症(GHD)的病例系列和人群。结果在1684篇出版物中,纳入了41项研究(33项儿童研究,8项成人研究)。所有研究都评估了人类负担。大多数儿童研究人群包括由于GHD导致的身材矮小,特发性身材矮小(ISS)和出生时小于胎龄(SGA)后身材矮小。在这些人群中,四项研究表明,身材矮小的儿童的生活质量(QoL)明显低于身材正常的儿童。在患有慢性肾脏疾病(CKD)(3项研究)、软骨发育不全(1项研究)和输血依赖性β-地中海贫血(1项研究)的儿童以及混合原因导致的身材矮小(3项研究)中,观察到生活质量与身材矮小之间的显著关联。三项研究(一项针对GHD/ISS/SGA,两项针对CKD)发现身材矮小与生活质量之间无显著关联,有几项研究未报告统计学意义。大约一半的成人研究表明,生活质量随着身材矮小而降低,而另一半则没有发现任何关联。两项研究,一项针对患有普瑞德-威利综合症的成年人,另一项针对患有GHD的儿童,都表明身材矮小和认知能力差之间存在潜在联系。三项研究表明,矮小儿童的父母照顾负担增加。结论有证据表明,与身高正常的人相比,任何原因导致的身高不足的儿童和成人的生活质量都较差。进一步的研究可以扩展我们对这一领域人类负担的理解。
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引用次数: 26
High-intensity interval exercise test stimulates growth hormone secretion in children 高强度间歇运动试验刺激儿童生长激素分泌
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101388
Nitzan Dror , Michal Pantanowitz , Dan Nemet , Alon Eliakim

Background

exercise stimulates growth hormone (GH) secretion and may serve as a promising physiological test for the diagnosis of GH deficiency. However, exercise standardization for a feasible GH test is still lacking. The aim of the present study was to examine the GH secretion to high intensity interval exercise.

Methods

Seventeen children (12.4 ± 2.6 years) with impaired growth rate performed high-intensity interval exercise test (HIIE) that included 10 intervals of 15 s all out pedaling against resistance determined by age, sex and weight on a cycle ergometer with 1-min active rest between each interval. Power output measurements were collected during the test. Blood samples were collected before, immediately after, 30, 45, and 60 min after the beginning of the exercise test. GH response was compered to pharmacological provocation test (clonidine or glucagon).

Results

HIIE led to a significant increase in GH levels (p < 0.001), with high correlation to GH response following pharmacological stimulation (r = 0.82, r = 0.80 for clonidine and glucagon respectively, p < 0.001) A significant correlation was found between mean peak power to body weight and the GH response (r = 0.50, p = 0.04). 83% of the participants who reached peak power > 10 watts/kg had normal GH secretion.

Conclusions

HIIE is a brief and individualized exercise protocol that may be used as a physiological provocation test for GH secretion. There might be a minimum of anaerobic power needed to induce adequate GH response during HIIE.

运动刺激生长激素(GH)的分泌,可能作为一种有前途的生理测试诊断GH缺乏症。然而,可行的生长激素测试的运动标准化仍然缺乏。本研究旨在探讨高强度间歇运动对生长激素分泌的影响。方法对17例(12.4±2.6岁)发育不良的儿童进行高强度间歇运动试验(HIIE),该试验包括10个15 s的间歇运动,每次间歇运动间隔1 min,根据年龄、性别和体重进行阻力测定。在测试期间收集功率输出测量值。分别在运动试验开始前、后、30、45和60分钟采集血样。将生长激素反应与药理学激发试验(可乐定或胰高血糖素)进行比较。结果ie导致GH水平显著升高(p <0.001),与药物刺激后的GH反应高度相关(可乐定和胰高血糖素分别为r = 0.82, r = 0.80, p <0.001)平均峰值功率与体重比与GH反应之间存在显著相关性(r = 0.50, p = 0.04)。83%达到峰值功率的参与者10瓦/kg生长激素分泌正常。结论shiie是一种简短的个体化运动方案,可作为生长激素分泌的生理激发试验。在HIIE期间,可能需要最小的厌氧功率来诱导足够的生长激素反应。
{"title":"High-intensity interval exercise test stimulates growth hormone secretion in children","authors":"Nitzan Dror ,&nbsp;Michal Pantanowitz ,&nbsp;Dan Nemet ,&nbsp;Alon Eliakim","doi":"10.1016/j.ghir.2021.101388","DOIUrl":"10.1016/j.ghir.2021.101388","url":null,"abstract":"<div><h3>Background</h3><p><span>exercise stimulates growth hormone (GH) secretion and may serve as a promising physiological test for the diagnosis of GH deficiency. However, exercise standardization for a feasible GH test is still lacking. The aim of the present study was to examine the GH secretion to </span>high intensity interval exercise.</p></div><div><h3>Methods</h3><p>Seventeen children (12.4 ± 2.6 years) with impaired growth rate performed high-intensity interval exercise test (HIIE) that included 10 intervals of 15 s all out pedaling against resistance determined by age, sex and weight on a cycle ergometer with 1-min active rest between each interval. Power output measurements were collected during the test. Blood samples were collected before, immediately after, 30, 45, and 60<!--> <!-->min after the beginning of the exercise test. GH response was compered to pharmacological provocation test (clonidine or glucagon).</p></div><div><h3>Results</h3><p>HIIE led to a significant increase in GH levels (<em>p</em><span> &lt; 0.001), with high correlation to GH response following pharmacological stimulation (</span><em>r</em> = 0.82, <em>r</em><span> = 0.80 for clonidine<span> and glucagon respectively, </span></span><em>p</em> &lt; 0.001) A significant correlation was found between mean peak power to body weight and the GH response (<em>r</em> = 0.50, <em>p</em> = 0.04). 83% of the participants who reached peak power &gt; 10 watts/kg had normal GH secretion.</p></div><div><h3>Conclusions</h3><p>HIIE is a brief and individualized exercise protocol that may be used as a physiological provocation test for GH secretion. There might be a minimum of anaerobic power needed to induce adequate GH response during HIIE.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38846905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The association between treatment and systemic inflammation in acromegaly 肢端肥大症治疗与全身性炎症的关系
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101391
T.L.C. Wolters , C.D.C.C. van der Heijden , O. Pinzariu , B.T.P. Hijmans-Kersten , C. Jacobs , C. Kaffa , A. Hoischen , M.G. Netea , J.W.A. Smit , D.H.J. Thijssen , C.E. Georgescu , N.P. Riksen , R.T. Netea-Maier

Objective

Acromegaly is characterized by an excess of growth hormone (GH) and insulin like growth-factor 1 (IGF1), and it is strongly associated with cardiovascular diseases (CVD). Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Previous results suggest the presence of systemic inflammation in treated patients. Here we assessed the association between treatment of acromegaly, systemic inflammation and vascular function.

Design

Ex vivo cytokine production and circulating inflammatory markers were assessed in peripheral blood from treated and untreated acromegaly patients (N = 120), and compared them with healthy controls. A more comprehensive prospective inflammatory and vascular assessment was conducted in a subgroup of six treatment-naive patients with follow-up during treatment.

Results

Circulating concentrations of VCAM1, E-selectin and MMP2 were higher in patients with uncontrolled disease, whereas the concentrations of IL18 were lower. In stimulated whole blood, cytokine production was skewed towards a more pro-inflammatory profile in patients, especially those with untreated disease. Prospective vascular measurements in untreated patients showed improvement of endothelial function during treatment.

Conclusions

Acromegaly patients are characterized by a pro-inflammatory phenotype, most pronounced in those with uncontrolled disease. Treatment only partially reverses this pro-inflammatory bias. These findings suggest that systemic inflammation could contribute to the increased risk of CVD in acromegaly patients.

目的肢端肥大症以生长激素(GH)和胰岛素样生长因子1 (IGF1)过量为特征,与心血管疾病(CVD)密切相关。急性和长期的促炎作用都归因于IGF1。先前的结果表明,在接受治疗的患者中存在全身性炎症。在这里,我们评估了肢端肥大症治疗、全身炎症和血管功能之间的关系。本研究评估了120例治疗和未治疗肢端肥大症患者外周血中细胞因子的产生和循环炎症标志物,并将其与健康对照进行比较。对6名治疗初期患者进行了更全面的前瞻性炎症和血管评估,并在治疗期间进行了随访。结果VCAM1、e -选择素和MMP2循环浓度在疾病未控制的患者中较高,而il - 18浓度较低。在受刺激的全血中,细胞因子的产生倾向于促炎,特别是那些未经治疗的疾病。未经治疗患者的前瞻性血管测量显示,治疗期间内皮功能有所改善。结论肢端肥大症患者具有促炎表型,在疾病不受控制的患者中最为明显。治疗只能部分逆转这种促炎偏向。这些发现表明,全身性炎症可能导致肢端肥大症患者心血管疾病的风险增加。
{"title":"The association between treatment and systemic inflammation in acromegaly","authors":"T.L.C. Wolters ,&nbsp;C.D.C.C. van der Heijden ,&nbsp;O. Pinzariu ,&nbsp;B.T.P. Hijmans-Kersten ,&nbsp;C. Jacobs ,&nbsp;C. Kaffa ,&nbsp;A. Hoischen ,&nbsp;M.G. Netea ,&nbsp;J.W.A. Smit ,&nbsp;D.H.J. Thijssen ,&nbsp;C.E. Georgescu ,&nbsp;N.P. Riksen ,&nbsp;R.T. Netea-Maier","doi":"10.1016/j.ghir.2021.101391","DOIUrl":"10.1016/j.ghir.2021.101391","url":null,"abstract":"<div><h3>Objective</h3><p>Acromegaly is characterized by an excess of growth hormone (GH) and insulin like growth-factor 1 (IGF1), and it is strongly associated with cardiovascular diseases (CVD). Both acute and long-lasting pro-inflammatory effects have been attributed to IGF1. Previous results suggest the presence of systemic inflammation in treated patients. Here we assessed the association between treatment of acromegaly, systemic inflammation and vascular function.</p></div><div><h3>Design</h3><p>Ex vivo cytokine production and circulating inflammatory markers were assessed in peripheral blood from treated and untreated acromegaly patients (<em>N</em> = <em>120</em>), and compared them with healthy controls. A more comprehensive prospective inflammatory and vascular assessment was conducted in a subgroup of six treatment-naive patients with follow-up during treatment.</p></div><div><h3>Results</h3><p>Circulating concentrations of VCAM1, <em>E</em>-selectin and MMP2 were higher in patients with uncontrolled disease, whereas the concentrations of IL18 were lower. In stimulated whole blood, cytokine production was skewed towards a more pro-inflammatory profile in patients, especially those with untreated disease. Prospective vascular measurements in untreated patients showed improvement of endothelial function during treatment.</p></div><div><h3>Conclusions</h3><p>Acromegaly patients are characterized by a pro-inflammatory phenotype, most pronounced in those with uncontrolled disease. Treatment only partially reverses this pro-inflammatory bias. These findings suggest that systemic inflammation could contribute to the increased risk of CVD in acromegaly patients.</p></div>","PeriodicalId":12803,"journal":{"name":"Growth Hormone & Igf Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ghir.2021.101391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38961204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
Growth hormone replacement may influence the biological action of thyroid hormone on liver and bone tissue 生长激素替代可能影响甲状腺激素对肝脏和骨组织的生物学作用
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-04-01 DOI: 10.1016/j.ghir.2021.101393
Nigel Glynn , David J. Halsall , Gerard Boran , Paul Cook , John H. McDermott , Diarmuid Smith , William Tormey , Christopher J. Thompson , Donal O'Gorman , Malachi J. McKenna , Amar Agha

Objective

Growth hormone (GH) replacement alters the peripheral interconversion of thyroxine (T4) and triiodothyronine (T3). However, little is known about the clinical impact of these alterations. We aimed to compare changes observed in the serum T3:T4 ratio with known biological markers of thyroid hormone action derived from different peripheral tissues.

Design

We prospectively studied twenty GH deficient men before and after GH replacement in a tertiary referral endocrine center. Serum biochemical measurements included insulin like growth factor-1 (IGF-1), thyroid hormones (free & total T3, free & total T4 and reverse T3) and TSH. Changes in thyroid hormone concentration were compared to alterations in hepatic and bone biomarkers of thyroid hormone action.

Results

GH replacement provoked a decline in serum free T4 concentration (−1.09 ± 1.99 pmol/L; p = 0.02) and an increase in free T3 (+0.34 ± 0.15 pmol/L; p = 0.03); therefore, the free T3:free T4 ratio increased from 0.40 ± 0.02 to 0.47 ± 0.02 (p = 0.002). Sex hormone binding globulin (SHBG) level was unchanged. However, a decline in serum ferritin (−26.6 ± 8.5 ng/mL; p = 0.005) correlated with a fall in freeT4. Alterations in lipid profile, including a rise in large HDL sub-fractions and Lp (a) (+2.1 ± 21.1 nmol/L; p = 0.002) did not correlate with thyroid hormone levels. Significant increases were recorded in serum bone turnover markers - procollagen type 1 amino-terminal propeptide +57.4%; p = 0.0009, osteocalcin +48.6%; p = 0.0007; c-terminal telopeptides of type 1 collagen +73.7%; p = 0.002. Changes in bone formation markers occurred in parallel with fluctuations in thyroid hormone.

Conclusion

GH-induced alterations in the thyroid axis are associated with complex, tissue specific effects on thyroid hormone action. Modulation of bone turnover markers suggests that GH may improve the biological action of thyroid hormone on bone.

目的:生长激素(GH)替代可改变外周甲状腺素(T4)和三碘甲状腺原氨酸(T3)的相互转化。然而,人们对这些改变的临床影响知之甚少。我们的目的是比较血清T3:T4比值的变化与来自不同外周组织的甲状腺激素作用的已知生物标志物。我们前瞻性地研究了20名在三级转诊内分泌中心接受激素替代治疗前后的生长激素缺乏男性。血清生化指标包括胰岛素样生长因子-1 (IGF-1)、甲状腺激素(游离&总T3,免费&总T4和逆转T3)和TSH。甲状腺激素浓度的变化与甲状腺激素作用的肝脏和骨骼生物标志物的变化进行了比较。结果gh替代引起血清游离T4浓度下降(- 1.09±1.99 pmol/L;p = 0.02),游离T3增加(+0.34±0.15 pmol/L;p = 0.03);游离T3:游离T4比值由0.40±0.02增加到0.47±0.02 (p = 0.002)。性激素结合球蛋白(SHBG)水平无变化。然而,血清铁蛋白下降(−26.6±8.5 ng/mL;p = 0.005)与freeT4的下降相关。脂质谱的改变,包括高密度脂蛋白亚组分和Lp (a)升高(+2.1±21.1 nmol/L;P = 0.002)与甲状腺激素水平无关。血清骨转换标志物-前胶原1型氨基末端前肽+57.4%;P = 0.0009,骨钙素+48.6%;p = 0.0007;1型胶原c端端肽+73.7%;p = 0.002。骨形成标志物的变化与甲状腺激素的波动同时发生。结论h诱导的甲状腺轴改变与甲状腺激素作用的复杂的组织特异性效应有关。骨转换标志物的调节表明生长激素可能改善甲状腺激素对骨的生物学作用。
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引用次数: 6
Prevalence of thyroid cancer in patients with acromegaly and non-growth hormone secreting pituitary adenomas: A prospective cross-sectional study 肢端肥大症和非生长激素分泌垂体腺瘤患者甲状腺癌的患病率:一项前瞻性横断面研究
IF 1.4 4区 医学 Q3 Medicine Pub Date : 2021-02-01 DOI: 10.1016/j.ghir.2021.101378
Isadora Yasbick Spricido, Carolina Monteguti Feckinghaus, Rômulo Henrique Malaquias Silva, Cleo Otaviano Mesa Junior, Cesar Luiz Boguszewski

Objective

To evaluate the prevalence of differentiated thyroid cancer (DTC) in patients with non-GH secreting pituitary adenomas [NGHPA group: non-functioning (NFPA), prolactin (PRL) and corticotropin (ACTH)-secreting adenomas] compared to patients with acromegaly, a pituitary disease that has been associated with increased risk for thyroid cancer.

Patients and methods

Prospective, cross-sectional study involving consecutive outpatients followed in our institution with diagnosis of acromegaly (n = 71; 43 women, median age 57 yrs) and NGHPA (n = 57; 38 women, median age 48 yrs.; PRL (n = 35), ACTH (n = 7), NFPA (n = 15). All participants were subjected to thyroid ultrasound (US) by the same examiner, and US-guided fine needle aspiration (FNA) biopsy when indicated.

Results

Thyroid volume was higher in acromegaly than in NGHPA (median 12.5 ml vs 6.3 ml; p < 0.0001), and thyroid nodules were present in 27/71 (38.0%) of acromegaly patients and in 14/57 (24.6%) of NGHPA group. FNA was indicated in 15/27 (55.5%) of acromegaly patients [Bethesda I (n = 1); II (n = 11), III (n = 1), two patients refused FNA], and in 8/14 (57.1%) of the NGHPA group [Bethesda I (n = 2); II (n = 4); V (n = 1); VI (n = 1)]. The two patients of NGHPA group with Bethesda V and VI were operated and papillary carcinoma was confirmed histologically.

Conclusion

DTC was not detected in our acromegaly patients and its presence in patients with NGHPA suggests that DTC predisposition is not related to GH excess.

目的比较非gh分泌垂体腺瘤[NGHPA组:无功能(NFPA)、泌乳素(PRL)和促肾上腺皮质激素(ACTH)分泌腺瘤]患者与肢端肥大症(一种与甲状腺癌风险增加相关的垂体疾病)患者分化型甲状腺癌(DTC)的患病率。患者和方法前瞻性横断面研究纳入我院诊断为肢端肥大症的连续门诊患者(n = 71;43名女性,中位年龄57岁)和NGHPA (n = 57;女性38人,中位年龄48岁;PRL (n = 35), ACTH (n = 7), NFPA (n = 15)。所有的参与者都接受了甲状腺超声检查(US),由同一名检查人员进行,并在需要时进行了超声引导下的细针穿刺活检(FNA)。结果肢端肥大症患者甲状腺体积高于NGHPA患者(中位12.5 ml vs 6.3 ml;p & lt;0.0001),肢端肥大症患者中27/71(38.0%)和NGHPA组中14/57(24.6%)存在甲状腺结节。27例肢端肥大症患者中有15例(55.5%)采用FNA [Bethesda I (n = 1);II (n = 11), III (n = 1), 2例患者拒绝FNA], 8/14(57.1%)的NGHPA组[Bethesda I (n = 2);II (n = 4);V (n = 1);VI (n = 1)]。NGHPA组2例患者行Bethesda V、VI手术,组织学证实乳头状癌。结论肢端肥大症患者中未检测到DTC, NGHPA患者中存在DTC提示DTC易感性与GH过量无关。
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引用次数: 5
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Growth Hormone & Igf Research
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