acromegaly 英/,ækrə(ʊ)'megəlɪ/ 美/,ækrə'mɛgəli/
释 义 n. [内科] 肢端肥大症
例 句 Human adults given growth hormone have suffered from acromegaly( excess bone growth) and carpal tunnel syndrome. 成年人给予生长激素，则会造成末端肥大（头过度生长）及腕管综合症。
作者： Mai C Arlien-Soborg
期刊：J Clin Endocrinol Metab
Fibroblast growth factor 21 (FGF21) is a circulating hormone predominantly secreted from the liver with pleiotropic effects on substrate metabolism. The FGF21 receptor (FGFR) is expressed in numerous tissues and its activation by FGF21 depends on binding to β-Klotho, which is a transmembrane cofactor. The activity of circulating FGF21 is also regulated by fibroblast activation protein (FAP), a protease that cleaves and inactivates circulating FGF21. Data in mice show that FGF21 induces weight loss, increases energy expenditure (EE), improves insulin sensitivity in muscle, liver and fat, and stimulates lipolysis. Administration of FGF21 analogues in humans induces weight loss and favourable changes in plasma lipids, increases adiponectin levels and reduces intrahepatic lipid (IHL) deposition. However, endogenous serum FGF21 levels are elevated in obese human subjects and in patients with type 2 diabetes, indicating resistance to its actions. In addition, FGF21 transgenic mice are small and live longer, which are linked to hepatic growth hormone (GH) resistance and ensuing low IGF-I levels. At the same time, GH-induced stimulation of hepatic FGF21 expression feedback inhibits GH signalling and action via several mechanisms. Experimental data on the interaction between FGF21 and GH/IGF-I in human subjects, on the other hand, are sparse, but prolonged GH administration (>3 weeks) increases serum FGF21 levels in healthy subjects. It is unknown if FAP levels or activity are influenced by GH, but it is noteworthy that collagens are recognized FAP substrates in as much as GH is a very powerful stimulator of collagen turnover in human subjects. Acromegaly, which is caused by a GH-producing pituitary adenoma, is characterized by elevated EE, lipolysis, insulin resistance, and increased collagen turnover. In the present prospective study, we measured circulating components of FGF21 including FAP in patients with acromegaly before and after disease control. Potential biomarkers of FGF21 action, including expression of putative FGF21-regulated genes in adipose tissue, were recorded together with biomarkers of collagen turnover as potential FAP substrates. The most prominent finding was that FAP was strongly associated with both biochemical disease activity and collagen turnover.