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为探讨瘦素与下丘脑垂体性腺轴、生长轴关系 ,选择12例原发性生长激素缺乏症(GHD)伴低促性腺激素睾丸发育不良患者(年龄 :15.3岁±1.2岁)及12例正常对照男童(14.3岁±0.2岁) ,GHD经重组人生长激素 (健豪宁 ,rhGH)0.1IU/(kg·d)治疗1年。两组均测血清瘦素、LH、FSH和睾酮。结果 :GHD组血清瘦素明显高于对照组(P<0.0001) ;血清瘦素与身高、体重和体块指数呈正相关(r=0.99,P<0.0001 ;r=0.98,P<0.0001 ;r=0.87,P<0.0001) ,与睾酮呈负相关(r= -0.42,P<0.001) ;经rhGH治疗后血清瘦素较治疗前显著降低(P<0.005)。提示 :①血清瘦素变化可涉及下丘脑垂体性腺轴和生长轴活动。②高浓度瘦素可影响促性腺激素和GH分泌 ;③由于雄激素能抑制瘦素合成与分泌 ,故睾酮低值可能与患者高瘦素血症有关 ;④rhGH能依赖体脂改变间接降低机体瘦素水平
In order to investigate the relationship between leptin and hypothalamic pituitary gland axis and growth axis, 12 patients with idiopathic hypogonadism (testis hypoplasia) undergoing primary hypogonadism (GHD) and hypogonadal testis dysplasia (age 15.3 ± 1.2 years) and 12 normal Control boy (14.3 ± 0.2 years), GHD treated with recombinant human growth hormone (Jian Hao Ning, rhGH 0.1IU / (kg · d) for 1 year. Serum leptin, LH, FSH and testosterone were measured in both groups. Results: Serum leptin in GHD group was significantly higher than that in control group (P <0.0001). Serum leptin was positively correlated with height, weight and body mass index (r = 0.99, P <0.0001; r = 0.87, P <0.0001), but negatively correlated with testosterone (r = -0.42, P <0.001). Serum leptin level was significantly lower after rhGH treatment than before treatment (P <0.005). Tip: ① serum leptin changes may involve the hypothalamus pituitary gland axis and growth axis activity. ② high concentration of leptin can affect the secretion of gonadotropin and GH; ③ as androgen can inhibit the synthesis and secretion of leptin, so the low testosterone may be related to patients with high serum leptin; ④ rhGH can rely on body fat to indirectly reduce the body’s leptin level