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成長ホルモンの欠乏症を有する成人における成長ホルモンの心臓への影響:メタ分析
Patrick Maison1, Philippe Chanson
1Department of Clinical Pharmacology and Clinical Research Unit, Assistance Publique-Hôpitaux de Paris, Henri Mondor University Hospital, Créteil and INSERM U258, Villejuif, France.
Circulation
|November 19, 2003
まとめ
成長ホルモン (GH) 治療は,GH欠乏症 (GHD) の成人における心臓の構造と機能を著しく改善します. エコーカルディオグラフィーは,左心室の質量と寸法にプラスの効果を示し,脳卒中量を高めました.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- 内科内科は,内科の内科である.
背景:
- 成長ホルモン (GH) 欠乏症 (GHD) は,成人における心臓の健康に影響を与える可能性があります.
- GHDの成人における心臓のパラメータに対するGH治療に関する以前の臨床試験では,サンプルサイズが限られ,アウトカムが変動していた.
- GH治療が心臓機能に与える正確な効果を理解することは,GHDの管理に不可欠です.
研究 の 目的:
- GH欠乏症 (GHD) の成人における成長ホルモン (GH) 治療による心臓のパラメータに対する効果を体系的にレビューし,分析する.
- 室内質量,寸法,機能を含む,エコーカルディオグラフィで評価された心臓メトリックに対するGH療法の影響を評価する.
- ランダム化比較試験と公開研究からの発見を統合し,GHDにおけるGHの心血管効果の包括的な概要を提供します.
主な方法:
- 盲検,プラセボ対照,ランダム化臨床試験および成人GHD患者におけるGH治療を含む公開試験の体系的レビュー.
- 合計468人の参加者を含む16件の試験 (9件のブラインド,7件のオープン) を含む.
- エコーカルディオグラフィのパラメータを組み合わせた分析:左心室質量 (LVM),中心室隔膜の厚さ (IVS),左心室後壁 (LVPW),左心室末シストリック (LVESD) と直径 (LVEDD),脳卒中容量,E/A比率,同位体リラクゼーション時間 (IRT),分数縮小.
主要な成果:
- GH治療は,左心室質量 (LVM) (+10.8 g,P=0.02) を有意に増加させた.
- 視界隔膜の厚さ (IVS) (+0.28 mm,P<0.001) と左心室後壁 (LVPW) (+0.98 mm,P=0.05) と左心室末端ダイアストリック直径 (LVEDD) (+1.34 mm,P<0.001) と脳卒中の体積 (+10.3 mL,P<0.001) の有意な増加が観察されました.
- 分割式短縮の改善の傾向が認められた (+1.1%,P=0.06),LVESD,E/A比率,IRTでは大きな変化はなかった.
結論:
- 成長ホルモン (GH) 治療は,左心室質量 (LVM),中心室隔膜の厚さ (IVS),左心室後壁 (LVPW),左心室末端透析直径 (LVEDD),およびGH欠乏症 (GHD) の成人の脳卒中量に顕著な肯定的な効果を示しています.
- これらの発見はエコーカルディオグラフィで評価され,心臓の形態学と機能の改善を示しています.
- この研究は,GH療法が成人におけるGHDに関連した心臓異常を改善する役割を支持しています.
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