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目的探讨肥胖儿童下丘脑_垂体轴分泌生长激素(GH)及促性腺激素(Gn)功能。方法采用复合刺激试验检测27例单纯性肥胖儿童和19例对照儿童。生长激素(GH)用放免法检测,促卵泡生成素(FSH)、促黄体生成素(LH)采用全自动荧光免疫分析系统测定。结果肥胖儿童的GH峰值(PGH)明显低于对照组(P<0.01);PGH<10μg/L者占肥胖儿童总数的88.89%。所有受试儿童血LH峰值(PLH)/LH基础值(BLH)均>3;PLH/PFSH(FSH峰值)比值在青春期肥胖和对照组均>0.7,但在青春期前肥胖组有4例>0.7;PLH值达到性腺轴发育标准者,在青春期肥胖组7例、对照组10例、青春期前肥胖组1例。有4例青春期前肥胖儿存在中枢性性早熟,占30.77%。结论肥胖儿垂体分泌GH功能和反应能力低下,但其身高正常,提示肥胖儿的生长调控机制较为复杂。采用PLH/PFSH比值和/或PLH值作为性腺轴功能成熟的判断标准较为理想。
Objective To investigate the secretion of growth hormone (GH) and gonadotropin (Gn) from the hypothalamus-pituitary axis in obese children. Methods A total of 27 simple obese children and 19 control children were tested by compound stimulation test. Growth hormone (GH) by radioimmunoassay, follicle stimulating hormone (FSH), luteinizing hormone (LH) using automated fluorescence immunoassay system. Results The GH peak (PGH) of obese children was significantly lower than that of the control group (P <0.01). The PGH <10 μg / L accounted for 88.89% of the total number of obese children. PLH / PFSH (peak value of PLH / PFSH) in adolescence was higher than that in control group (P> 0.7), but in pre-adolescent obesity group, there were> 0.7 ; PLH value reached the gonadal axis developmental standards, 7 cases in adolescent obesity group, control group 10 cases, pre-adolescent obesity group 1 case. There are 4 cases of premature puberty in children with precocious puberty, accounting for 30.77%. Conclusion Obese children have hypopituitaristic GH function and response to hypogonadism, but their height is normal, suggesting that the mechanism of obesity is more complicated. The use of PLH / PFSH ratios and / or PLH values as a criterion for maturity of the gonadal axis is ideal.