·糖尿病临床研究·

　　【摘要】目的 评价垂体生长激素瘤(GH-secreting pituitary adenoma)患者血清激素水平的改变及其与糖代谢异常的关系。方法 检测GH-secreting pituitary adenoma (GH-secreting pituitary adenoma组)患者BP、血生长激素(GH)、IGF-1及泌乳素，并行OGTT，计算ISI、稳态模型胰岛素抵抗指数(HOMA IR)、葡萄糖及胰岛素曲线下面积(AUCg，AUCi)，将所得结果与垂体无功能瘤(NPA组)及糖代谢正常(NGT组)者比较。结果 GH-secreting pituitary adenoma组血GH、IGF-1、IGF-1%及泌乳素高于其他两组(P<0.01)。GH-secreting pituitary adenoma组高血糖患病率高于NPA组及NGT组(39.4% vs 19.4% vs 18.4%);IGR(21.2% vs 12.9% vs 10.2%)及糖尿病(18.2% vs 6.5% vs 8.2%)患病率高于NPA组。GH-secreting pituitary adenoma组FPG、OGTT 2 hPG高于NGT组，ISI则低于NGT组(P<0.05或P<0.01);FIns、AUCg、AUCi及HOMA-IR高于其他两组(P<0.05或P<0.01)。根据OGTT结果将GH-secreting pituitary adenoma组分为两亚组，高血糖亚组血GH高于血糖正常组。相关性分析结果显示，GH-secreting pituitary adenoma组血GH与FPG、2 hPG及AUCg呈正相关;IGF-1%与2 hPG及AUCg呈正相关。结论 GH-secreting pituitary adenoma患者高血糖患病率升高，且其原因与GH高分泌相关。

　　【关键词】垂体生长激素瘤;高血糖;糖尿病

Changes of serum hormonal levels and the relationship with abnormal glucose metabolism in patients with growth hormone-secreting pituitary adenoma ZHANG Wei, ZHANG Zheng, XU Er-li. Department of Endocrinology, PLA 411 Hospital, Shanghai 200081, China

Corresponding author：XU Er-li，E-mail：erlixu@gmail.com

　　【Abstract】 Objective The purpose of the study was to evaluate look for some changes of serum hormonal levels and the their relationship with abnormal glucose metabolism in patients with growth hormone secreting pituitary adenoma. Methods Sixty-six patients with of growth hormone-secreting pituitary adenoma were evaluated. All of them measured blood Blood pressure, plasma growth hormone (GH), insulin like growth factor-1 (IGF-1) and prolactin (PRL) were measured. They underwent oral Oral glucose tolerance test (OGTT) was performed to calculate insulin index (ISI), insulin resistance homeostasis (HOMA-IR), area under the curves of glucose (AUCg) and insulin (AUCi). Then, The the results were compared with 31 patients of nonfunctional pituitary adenoma and 40 control cases. Results The plasma GH, IGF-1, IGF-1% and PRL in patients of GH-secreting pituitary adenoma group were higher than in nonfunctional pituitary adenoma and control groups. As defined by WHO, the prevalence of hyperglycemia was 39.4% in GH-secreting pituitary adenoma group, including 21.2% patients of glucose intolerance and 18.2% patients of diabetes mellitus. The data was higher than in nonfunctional pituitary adenoma group. The fasting and 2h postprandial glucose in GH-secreting pituitary adenoma group was higher in GH-secreting pituitary adenoma group than in nonfunctional pituitary adenoma groups, and the ISI was lower(P<0.05 or P<0.01). The fasting insulin (FIns), AUCg, AUCi and HOMA-IR in GH-secreting pituitary adenoma group were higher in GH-secreting pituitary adenoma group than in nonfunctional pituitary adenoma and control groups(P<0.05 or P<0.01). According to the results of OGTT, we divided all GH-secreting pituitary adenoma patients into with or without hyperglycemia groups. The patients with hyperglycemia had higher plasma GH than those of without hyperglycemia. The level of plasma GH was positively correlated with fasting, 2h postprandial glucose (2 hPG) and AUCg in GH-secreting pituitary adenoma patients.The level of IGF-1% was positive correlated with 2 hPG and AUCg. Conclusion Our study indicates that patients with GH-secreting pituitary adenoma have a significantly higher prevalence of hyperglycemia. And i It is related with over secretion of growth hormone.

　　【Key words】Growth hormone hormone-secreting pituitary adenoma;Hyperglycemia;Diabete mellitus