低剂量生理生长激素在艾滋病毒和腹部脂肪积累的患者:一个随机对照试验
Janet Lo1, Sung Min You, Bridget Canavan
1Program in Nutritional Metabolism, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.
JAMA
|August 5, 2008
概括
低剂量生长激素 (GH) 治疗艾滋病毒患者减少了内脏脂肪和改善了心血管标志物,但增加了葡萄糖水平. 这项研究研究了艾滋病毒患者的GH对身体组成和代谢健康的影响,这些患者的腹部脂肪积累和GH缺乏.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 代谢综合征是代谢综合征的一种.
背景情况:
- 艾滋病毒患者的抗逆转录病毒疗法 (ART) 与内脏脂肪,代谢并发症和心血管风险增加有关.
- 减少生长激素 (GH) 分泌可能有助于在接受ART的HIV患者中产生这些不良影响.
- 在这种患者群体中,腹部脂肪积累和相对GH缺乏是常见的.
研究的目的:
- 为了评估低剂量生理GH给药对人体构成的影响.
- 评估艾滋病毒患者腹部肥胖和GH缺乏症的葡萄糖代谢和心血管参数的变化.
- 在这个特定的患者群体中研究GH治疗的疗效和安全性.
主要方法:
- 一个随机,双盲,安慰剂对照试验,涉及56名艾滋病毒患者的腹部脂肪和减少GH分泌.
- 参与者在18个月内接受皮下GH或安慰剂,GH剂量定位为正常IGF-1范围的上四分位数.
- 使用CT扫描和DXA评估身体组成;二级结局包括葡萄糖,IGF-1,血压和脂质.
主要成果:
- 与安慰剂相比,GH治疗显著减少了内脏脂肪组织区域和干部脂肪.
- 随着GH的使用,在透气血压和甘油三水平上观察到显著的改善.
- 胰岛素样生长因子1 (IGF-1) 水平增加,而在GH组中,在葡萄糖耐受性测试期间的2小时葡萄糖水平升高.
结论:
- 18个月的低剂量GH治疗有效降低了GH缺乏症的HIV患者的内脏脂肪和骨干肥胖.
- GH治疗也改善了甘油三和透血压,有助于改善心血管风险概况.
- 然而,2小时后葡萄糖水平的增加需要在治疗期间仔细监测葡萄糖代谢.
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