Роль глюкозы и инсулина в метаболической регуляции секреции гормона роста

Точные физиологические основы подавления секреции гормона роста пероральным приемом глюкозы на сегодняшний день остаются неизвестными, несмотря на широкое применение перорального глюкозотолерантного ­теста в эндокринологии. Отсутствие подавления гормона роста глюкозой встречается примерно у трети пациентов с акромегалией, а также при других расстройствах. В настоящее время известно, что на секрецию гормона роста воздействуют различные факторы, такие как возраст, пол, индекс массы тела и перераспределение жировой ткани. Также появляются данные о влиянии на секрецию гормона роста не только избыточной массы тела, но и переедания. Как ­известно, оба этих состояния связаны с гиперинсулинемией, что определяет возможность ее преимущественной роли в подавлении секреции гормона роста. Целью данного обзора является обсуждение накопленных данных об изолированном влиянии на секрецию гормона роста гипергликемии и гиперинсулинемии, а также других метаболических регуляторов и состояний, влияющих на его сигналинг. Понимание патофизиологических основ этих механизмов необходимо для дальнейших исследований роли глюкозы и инсулина в метаболической регуляции секреции гормона роста. При этом важно учитывать, что исследования на животных моделях затруднены межвидовыми различиями в ответе гормона роста на нагрузку глюкозой, и единственной возможной доступной моделью у здоровых людей авторам представляется использование гиперинсулинемического эугликемического клэмп-теста.

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