성장호르몬 결핍증 환아에서 성장호르몬의 투여가 체구성과 지방분해에 미치는 영향

Abstract

[한글]

성장 호르몬은 골조직뿐만이 아니라 신체의 모든 조직의 성장을 조절하는 가장 중요한 호르몬이다. 성장 호르몬 결핍시에는 피하지방의 축적이 오고 성장 호르몬의 투여가 축적된 지방의 분해 및 산화를 증가시켜 체구성(body composition)의 변화를 일으키는 것으로

알려져 있다. 따라서 성장 호르몬이 체구성과 지방 분해에 어떤 영향을 미치는지 규명하기 위하여 연세의료원에 내원한 환아중 신장이 정상 표준치의 2표준편차이하이며 전형적인 성장 호르몬 유발 검사상 성장 호르몬 결핍성 왜소증으로 진단받은 환아 6명과 성장 호르몬 정상 왜소증으로 진단된 환아 35명을 대상으로 성장 호르몬의 투여가 체구성에 미치는 영향을 관찰하였다.

체구성의 지표로는 body fat %, fat weight, fat free weight를 측정하고 지방분해에 미치는 영향을 보기 위하여 콜레스테롤, 고밀도 지단백 콜레스테롤 (HDL-cholesterol), 중성지방(triglyceride), 유리지방산 (free fatty acid) 을 측정하고 인슐린양 성장인자-1 (Insulin like growth factor-1)을 측정하여 다음과 같은 결과를 얻었다.

성장 호르몬 투여로 신장은 통계적으로 유의하게 증가하였으나, body fat %, FW, FFW는 성장 호르몬 결핍성 왜소증 환아에서 투여전후에 유의한 차이는 없었으며 성장 호르몬 정상 왜소증 환아에서는 투여전에 비해 FFW만이 유의하게 증가하였다.

성장 호르몬 결핍성 왜소증 환아에서 콜래스테롤, 고밀도 지단백 콜레스테롤, 중성지방, 유리지방산 등 지질 인자들은 성장 호르몬 투여전후에 유의한 차이는 없었다. 성장 호르몬 정상 왜소증 환아에서는 고밀도 지단백 콜레스테롤이 유의하게 감소하였을 뿐 콜레

스테롤, 중성지방, 유리지방산 등은 성장 호르몬 투여 전후에 차이는 없었다.

본 연구 결과에서 보면 성장 호르몬의 투여가 골성장에는 영향을 미치나 성장 호르몬 결핍성 왜소증 환아의 체구성 지표나 지질인자에는 통계적으로 유의하게 영향을 미치지 않는 것으로 보인다.

Effects of systemic growth hormone administration on body composition and lipolysis

in growth hormone defficient children

Kyung Eun Oh

Department of Medical Science The Graduate School, Yonsei University

(Directed by Professor Duk Hi Kim)

Growth hormone has profound effects not only on growth but also on body

composition and metabolism. It is well known that growth hormone has a lipolytic

effect. In order to assess the potential relationship between the effects of human

growth hormone on body composition and lipolysis, body fat %, fat weight, fat free

weight, cholesterol, high density lipoprotein, triglyceride, free fatty acid, and

insulin like growth factor-1 were measured.

The results were as follows:

Growth hormone therapy was carried out in 6 growth hormone deficient children (5

boys, 1 girl: mean[SD] age 11.9[2.5] years) and 35 non-growth hormone deficient

short stature (17 boys, 18 girls: mean[SD] age, 12.7[1.9] fears).

The treatment of growth hormone in complete growth hormone deficienct patients

significantly (p＜0.05) increased mean height, but body weight, body fat %, FW,

FFW, cholesterol, HDL-cholesterol, triglyceride, and FFA were not changed. In

non-growth hormone deficient short stature, the treatment of growth hormone

significantly increased mean height, weight, and FFW. While HDL-cholesterol was

decreased. However body fat%, FW, cholesterol, triglyceride, and FFA were not

changed after successful growth hormone therapy. Mean IGF-1 levels were elevated

after growth hormone treatment compared with those before therapy in both growth

hormone deficient and non-growth hormone deficient groups. Changes in FFW were

correlated with weight but were not correlated with other parameters in two groups.

Thus unexpectedly daily exogenous growth hormone treatment did not seem to alter

the body composition and fat free weight, However conclusion can not be drawn from

present study on the effect of growth hormone on the body composition and lipolysis

due to the small number of subjects, different duration of therapy, and individual

variance of subjects in the present study. Further studies are required to clarify

the effect of growth hormone on this matter

[영문]

Growth hormone has profound effects not only on growth but also on body composition and metabolism. It is well known that growth hormone has a lipolytic effect. In order to assess the potential relationship between the effects of human growth hormone on body composition and lipolysis, body fat %, fat weight, fat free weight, cholesterol, high density lipoprotein, triglyceride, free fatty acid, and insulin like growth factor-1 were measured.

The results were as follows:

Growth hormone therapy was carried out in 6 growth hormone deficient children (5 boys, 1 girl: mean[SD] age 11.9[2.5] years) and 35 non-growth hormone deficient short stature (17 boys, 18 girls: mean[SD] age, 12.7[1.9] fears).

The treatment of growth hormone in complete growth hormone deficienct patients significantly (p＜0.05) increased mean height, but body weight, body fat %, FW, FFW, cholesterol, HDL-cholesterol, triglyceride, and FFA were not changed. In

non-growth hormone deficient short stature, the treatment of growth hormone significantly increased mean height, weight, and FFW. While HDL-cholesterol was decreased. However body fat%, FW, cholesterol, triglyceride, and FFA were not changed after successful growth hormone therapy. Mean IGF-1 levels were elevated after growth hormone treatment compared with those before therapy in both growth hormone deficient and non-growth hormone deficient groups. Changes in FFW were correlated with weight but were not correlated with other parameters in two groups.

Thus unexpectedly daily exogenous growth hormone treatment did not seem to alter the body composition and fat free weight, However conclusion can not be drawn from present study on the effect of growth hormone on the body composition and lipolysis

due to the small number of subjects, different duration of therapy, and individual variance of subjects in the present study. Further studies are required to clarify the effect of growth hormone on this matter