瘦素与肥胖女孩特发性中枢性性早熟的关系

Relationship between leptin and idiopathic central precocious puberty in obese girls

目的探讨瘦素对青春期启动的影响,瘦素与性腺轴激素之间的关系及其在肥胖女孩特发性中枢性性早熟(ICPP)发生中的作用。方法56例符合现行诊断标准的ICPP女孩,按是否肥胖分为2组:肥胖的ICPP组18例,非肥胖ICPP组38例,年龄匹配的青春期前儿童分为非肥胖未发育组25名,肥胖未发育组18名。测定其空腹血清瘦素、FSH、LH和雌二醇(E2)水平。结果与非肥胖未发育组血清瘦素浓度[(4.1±1.5)μg/L]比较,肥胖的ICPP组[(14.7±7.5)μg/L]、非肥胖的ICPP组[(8.8±5.1)μg/L]和肥胖未发育组[(8.0±5.3)μg/L]均明显升高(P<0.01或P<0.05);肥胖的ICPP组还明显高于肥胖未发育组及非肥胖的ICPP组(均P<0.05),但是肥胖未发育组及非肥胖的ICPP组之间差异无统计学意义。结论瘦素参与青春期发育的启动,肥胖女孩存在瘦素抵抗,肥胖女孩的高瘦素血症并非是引起其青春期发动提前的主要诱发因素。

Objective To explorethe influence of leptin on the onset of puberty, and to study the relationship between leptin and hormones relevant to gonadal axis and its effect on idiopathic central precocious puberty (ICPP) in obese girls. Methods Fifty-six girls with ICPP fulfilled the current diagnostic criteria and came from pediatric endocrinology clinic. The 56 cases were divided into 2 groups according to whether there was obesity or not: 38 non-obese girls with ICPP and 18 obese girls with ICPP. Forty-three age-matched prepubertal girls were divided into non-obese prepuberty group (25 girls) and obese prepuberty group (18 girls). Serum leptin wasassayedwithELISA,andserum FSH, LH and E 2 were determined with immunochemiluminescent. Results As compared with non-obese prepuberty group [(4.1±1.5)μg/L], the leptin concentrations in obese ICPP group [(14.7±7.5)μg/L], non-obese ICPP group [(8.8±5.1)μg/L] and obese prepuberty group [(8.0±5.3)μg/L] were significantly higher (P<0.01 or P<0.05). Besides, the leptin concentration in obese ICPP group was significantly higher than those in obese prepuberty group and non-obese ICPP group (both P<0.05). But there was no difference in the leptin concentrations between obese prepuberty group and non-obese ICPP group. Conclusions Leptin takes part in the onset of puberty. Leptin resistance exists in obese girls, indicating that high leptin concentration is not a main precipitating cause of early onset of puberty in obese girls.