促性腺激素释放激素类似物对特发性中枢性性早熟女童糖脂代谢的影响  

Effects of gonadotropin-releasing hormone analog treatment on glucose and lipid metabolism in girls with idio- pathic central precocious puberty

作　　者：张龙江[1] 冼雄辉[2] 加子珍 包忠宪[2] 王姝彦[2] 

机构地区：[1]深圳市儿童医院内分泌科,518026 [2]广东医学院附属深圳南山人民医院儿科 [3]深圳市西丽人民医院妇产科

出　　处：《中华实用儿科临床杂志》2013年第20期1552-1554,共3页Chinese Journal of Applied Clinical Pediatrics

基　　金：深圳市科技计划项目（200903278）

摘　　要：目的观察促性腺激素释放激素类似物对特发性中枢性性早熟（ICPP）女童糖脂代谢的影响。方法选取2008年1月至2011年6月深圳市儿童医院内分泌专科确诊为ICPP，年龄6—8岁，乳房Tanner分期为B2期，应用曲普瑞林治疗达12个月的患儿26例。观察治疗前、治疗6个月、治疗12个月患儿体质量指数（BMI）、空腹血糖、空腹胰岛素、血脂水平（总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、载脂蛋白A、载脂蛋白B）及雌激素（E：）水平的改变。采用稳态模型胰岛素抵抗指数（HOMA—IR）评估胰岛素敏感性，并与年龄、性别匹配的青春前期健康儿童（健康对照组）进行比较。结果1．治疗前ICPP女童BMI、空腹血糖、空腹胰岛素及HOMA—IR与健康对照组比较差异均无统计学意义。2．曲普瑞林治疗6个月时，ICPP患儿血清E：水平较治疗前明显下降[（11．2±4．6）ng／L比（30．5±9．8）ng／L，P〈0．01]；治疗12个月时患儿空腹血糖、空腹胰岛素与治疗前比较差异均无统计学意义，但BMI从治疗前的（16．46±1．10）kg／m。增加到（18．35±1．30）kg／m2，差异有统计学意义（P〈0．05）；HOMA—IR从治疗前的1．24±0．30增加到2．08±0．40，差异有统计学意义（P〈0．05）。3．曲普瑞林治疗前后ICPP患儿的血脂水平无明显变化。结论促性腺激素释放激素类似物治疗12个月可增加ICPP患儿BMI，降低患儿的胰岛素敏感性。Objective To assess the effects of gonadotropin-releasing hormone analog on glucose and lipid me- tabolism in girls with idiopathic central precocious puberty（ICPP）. Methods A total of 26 girls （ aged 6-8 years, breast stage B2） with ICPP were followed up in Department of Endocrinology, Shenzhen Children＇s Hospital from Jan. 2008 to Jun. 2011. Those girls received triptorelin therapy for 12 months. Before and the end of the 6th month, the 12th month of the treatment,body mass index（BMI） was calculated,fasting plasma glucose（FPG） ,fasting plasma insulin（FPI） ,total cholesterol, triacylglycerols, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A, apolipoprotein B and estradiol（ E2 ） were measured. Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance（HOMA-IR）. Twenty age-matched prepuberty girls were set as controls. Results 1. Before treat- ment, BMI, FPG, FPI and HOMA-IR in ICPP girls had no significant difference compared with the controls. 2. After 6 months treatment of triptrolin,serum E2 concentration in ICPP girls declined from（30.5 ± 9.8 ） ng/L at the beginning of treatment to （11.2 ＋ 4.6） ng/L at the end of 6＇h month（ P 〈 O. 01 ） ;The end of 12＇h month of the treatment, FPG and FPI had no significant difference compared with that before of the treatment, but BMI increased from （ 16.46 ＋ 1.10 ） kg/m2 to（ 18.35 ± 1.30） kg/m2 ,the difference was significant（ P 〈 0.05 ） , HOMA-IR increased from 1.24 ± 0.30 to 2.08 ± 0.40, the difference was significant （P 〈 0.05 ）. 3. Lipid metabolism parameters remained unchangeable after 12 months of triptrolin treatment. Conclusion Triptorelin may lead to raise of BMI and HOMA-IR in girls with ICPP at 12 months after treatment.

关 键 词：特发性中枢性性早熟 促性腺激素释放激素类似物 体质量指数 胰岛素抵抗 

分 类 号：R725.8[医药卫生—儿科]