기능적 성장호르몬 결핍을 보이는 성인에서 6개월간의 성장호르몬 보충요법이 체성분 및 주관적 신체 기능에 미치는 효과 = Effects of rhGH on Body Composition and Subjective Physical Functions in Adults with Functional Growth Hormone Deficiency

다국어 초록 (Multilingual Abstract)

Background: There is a significant amount of evidence to indicate that some of the changes attributed to aging process can be partially reversed by GH replacement. But the GH replacement for somatopause with functional GH deficiency is still controversial. The aim of this study was to explore whether the short term GH replacement improved physical, emotional and sexual function as well as body composition.
Methods: A total of 31 adults with functional growth hormone deficiency were assigned to receive rhGH with an initial daily dose of 1.05 IU, six times a week. For evaluating physical change a 25-item questionnaire was administered to patients at initial visit and 6 months later. Body composition was determined by bioimpedence analysis at initial visit and 6 months later as well. We compared the changes for each variable using Wilcoxon's rank and Friedman's test.
Results: Serum IGF-1 level at 3 and 6 months were increased significantly by 31% and 43%, respectively, compared to baseline (P＜0.0001). Lean body mass and percent body fat at 6 months of treatment showed a 2.2% increase and a 7.6% decrease with statistical significance. The score of the questionnaire at 6 months of treatment increased significantly in physical changes (P＜0.0005), sexual function (P＜0.001), self perception of physical appearances (P＜0.02), chronic fatigue & immunity (P＜0.03), and vitality (P＜0.05).
Conclusion: Adults with functional growth hormone deficiency showed improvements in not only body composition, but also physical function and appearances and sexual function after 6 months of treatment with rhHGH.

국문 초록 (Abstract)

연구배경: 최근 일부 노인에서 성장호르몬 보충요법이 노화와 관련된 신체적 특성들을 가역적으로 변화시킬 수 있음이 보고되고 있다. 그러나 뇌하수체 질환이 없는 정상 성인에 대한 성장호르몬 치료 효과는 아직도 논란이 있다. 본 연구는 기능적 성장호르몬 결핍을 보이는 성인에서 단기간 성장호르몬 보충요법 후 체성분과 환자가 느끼는 신체 기능 변화를 평가하기 위해 시행되었다.
방법: L-dopa 자극 검사에서 최대 자극치가 5 μg/L 이하이거나 혈 중 인슐린 양 성장인자-1의 농도가 200 ng/mL 이하인 40세 이상 성인 남녀 31명을 대상으로 6개월간 성장호르몬(Saizen, Serono, Switzerland) 1.05 IU를 주 6회 취침 전 피하주사한 후, 체성분 변화와 설문지 응답 차이를 짝을 이룬 비모수 검정으로 알아보았다. 인슐린 양 성장인자-1 농도는 치료 전, 3개월, 6개월에 측정하여 차이를 비교하였다.
결과: 인슐린 양 성장인자-1농도는 치료 전 평균 209.1±69.8 ng/ml에서 3개월에 274±99.3 ng/ml, 6개월에 301.0±48.1 ng/ml로 유의하게 증가되었다(P＜0.0001). 치료 6개월 후 근육량은 유의하게 증가(P＜0.005), 체 지방률은 유의하게 감소하였다(P＜0.01). 지방량, 체중, 허리둘레의 변화는 없었다. 설문지 조사에서 총점은 치료 후에 유의하게 높아 졌다(P＜0.0005). 또한 피부, 머리카락, 손톱, 근육 등 신체변화를 묻는 문항들과(P＜0.0005) 성 기능 향상(P＜0.001), 자신의 신체 외모 변화(P＜0.02), 만성피로와 저항력(P＜0.03), 활력 증가(P＜0.05) 등의 문항 영역에서 유의한 차이를 보였다. 인지기능, 정서 및 수면 장애 등의 영역은 치료 전후의 차이가 없었다.
결론: 기능적 성장호르몬 결핍을 보이는 정상 성인에서 단기간 성장호르몬 보충요법으로 근육량 증가, 체지방률 감소, 일부 신체적 기능의 향상이 나타남을 알 수 있었다.

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