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 1.6 4区 医学 Q4 CELL BIOLOGY Growth Hormone & Igf Research 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
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引用次数: 6

摘要

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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Growth hormone replacement may influence the biological action of thyroid hormone on liver and bone tissue

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.

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来源期刊
Growth Hormone & Igf Research
Growth Hormone & Igf Research 医学-内分泌学与代谢
CiteScore
3.30
自引率
0.00%
发文量
38
审稿时长
57 days
期刊介绍: Growth Hormone & IGF Research is a forum for research on the regulation of growth and metabolism in humans, animals, tissues and cells. It publishes articles on all aspects of growth-promoting and growth-inhibiting hormones and factors, with particular emphasis on insulin-like growth factors (IGFs) and growth hormone. This reflects the increasing importance of growth hormone and IGFs in clinical medicine and in the treatment of diseases.
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