폐경 후 여성에서 저용량 성장 호르몬 요법이 골밀도, 인슐린양 성장인자, 악력 및 체지방과 혈중 지질 성분에 미치는 영향에 대한 연구
A study of the effect of low dose recombinant human growth hormone replacement therapy on bone mineral density, IGF-1, hand grip strength, body fat and serum lipid compositionsin postmenopausal women
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목적: 폐경 후 여성에서 저용량 성장 호르몬 요법이 골밀도에 미치는 영향에 대해 알아보고자 본 연구를 시행하였다. 연구 방법: 2003년 10월에서 2004년 3월까지 6개월 간 순천향대학교 천안병원 산부인과 외래에서 저용량 성장 호르몬 치료를 받은 폐경 후 여성 9명을 대상으로 생화학적 골지표와 골밀도 변화를 측정하여 그 변화를 비교 분석하였다. 결과: 다음과 같은 결과를 얻었다. 1. 환자의 평균 연령은 62.2±2.7세 였다. 2. 오스테오칼신은 치료 후 3개월에 28%, 6개월에는 35%의 유의한 증가를 보였다. 3. 혈중 IGF-1의 수치는 치료 1개월, 3개월과 6개월에 치료 전과 비교하여 유의한 증가를 보였다. 4. 요추골과 대퇴골의 골밀도는 증가를 보이기는 하였으나 유의한 차이는 없었다. 5. 악력 (hand grip strength)는 치료 6개월 후에 유의한 증가를 보였다. 6. 체지방은 치료 6개월 후 0.75%의 감소를 보였으나 유의한 차이는 없었다. 7. 혈중의 총 콜레스테롤, TG와 LDL cholesterol은 유의하지는 않으나 감소를 보였고, HDL cholesterol은 증가를 보였으나 유의한 차이는 없었다. 결론: 저용량의 성장호르몬을 폐경기 여성에게 사용했을 때 골밀도, 악력 그리고 HDL cholesterol을 증가시키는 것을 알 수 있었다. 이 연구를 토대로 저용량 성장호르몬을 골다공증이 있는 폐경 여성에게 사용 시 골밀도의 증가와 함께 추가적인 이익을 기대해 볼 수 있다.
Abstract
Objective: To determine the effect of low-dose growth hormone (GH) replacement therapy on bone mineral density at the lumbar spine and femur, IGF-1, hand grip, body fat and serum lipid compositions in postmenopausal women. Methods: A total of 9 postmenopausal women were assigned to receive growth hormone with a daily dose 0.0095 IU/kg, six times a week. We compared the change of bone marrow density (BMD), bone marker (osteocalcin), IGF-1, hand grip strength, body fat and serum lipid compositions during therapy. Repeated measure ANOVA test was used for statistical analysis. Results: The results were as follows. 1. Mean age of the patients was 62.2±2.7 years. 2. The bone marker, osteocalcin level at 3 and 6 months were increased by 28% and 35% respectively, compared to baseline (p<0.05). 3. Serum IGF-1 level at 1, 3 and 6 months were increased by 61%, 46% and 15% respectively, compared to baseline (p<0.05). 4. Lumbar and spine bone marrow density (BMD) were increased during GH treament, but not significant (p>0.05). 5. Hand grip strength at 6 months was increased by 7.8% compared to baseline (p<0.05). 6. The body fat composition at 6 months treament was showed a o.75% decrease with no statistical significance (p>0.05). 7. The total cholesterol, triglyceride and LDL cholesterol were decreased during GH treament, but not significance (p>0.05). The HDL cholesterol was increased with no statistical significance (p>0.05). Conclusion: Our study results suggest that low-dose GH replacement therapy in postmenopausal women have beneficial effect on increased BMD, hand grip strength and HDL cholesterol. The present findings provide useful information regarding the use of low-dose GH treament in elderly women with osteoporosis
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