原发性生长激素缺乏症与高瘦素血症  

Primary growth hormone deficiency and hyperleptinaemia

作　　者：王伟[1] 倪继红[1] 崔贻芬[1] 孙文鑫[1] 陈凤生[1] 王德芬[1] 

机构地区：[1]上海第二医科大学附属瑞金医院儿内科,上海200025

出　　处：《临床儿科杂志》2002年第10期611-613,共3页Journal of Clinical Pediatrics

摘　　要：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 ;To explore the relationships either between leptin and hypothalamic-pituitary-insulin-like growth factor axis or between leptin and hypothalamic-pituitary-gonad axis,serum leptin,LH,FSH and testosterone were determined in 12 boys with both of primary growth hormone deficiency (GHD)and hypogonadotropic hypogonadism(aged 15.3±1.2 years)and 12 normal boys(aged 14.3±0.2 years),respectively.GHD boys received recombinant growth hormone(Genetopin)0.1 IU/(kg·d)for one year.The results showed that serum leptin levels were significantly higher in GHD boys than those in normal boys(P<0.0001).A multiple regression analyses showed that serum leptin levels were positively correlated to height(r=0.99,P<0.0001),weight(r=0.98,P<0.0001)and body mass index(r=0.87,P<0.0001),and negatively correlated to serum testosterone(r=-0.42,P<0.001).It was noticed that serum leptin levels decreased obviously after Gen-etropin treatment comparing to those before treatment(P<0.005).It is suggested that 1)The change of serum leptin levels may be related to both of hypothalamic-pituitary-insulin-like growth factor axis and hypothalamic-pituitary-gonad axis.2)The secretion of ganadotropin and growth hormone can be influenced by hyperleptinaemia.3)Owing to androgen can induce a decrease of serun leptin levels,hypotestosteronamia may probably be related to hyperleptinaemia.4)Exogenous growth hormone can have an indirect effect on decrease of serum leptin levels through the change of fat mass.

关 键 词：瘦素 生长激素 青春发育 原发性生长激素缺乏症 高瘦素血症 

分 类 号：R725.8[医药卫生—儿科]