13岁儿童肥胖发生相关因子与青春期发育相关激素分泌及其关系研究

Study on the level changes of obesity-associated factors and puberty-associated hormones and their relationship between obese and normal 13 years old children

目的分析儿童肥胖形成中肥胖发生调节因子及与青春期发育相关激素的变化,探讨这些激素在青春期儿童肥胖形成中的变化特点及其相互关系。方法以78例肥胖的13岁儿童和84例同岁正常对照儿童为研究对象,以放射免疫法测定血中食欲素(orexins)、瘦素(leptin)、胰岛素(insulin)及睾酮(T)、雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)等浓度,计算骨龄(BA)。结果肥胖儿童血中leptin、insulin浓度显著高于对照组浓度(P<0·01);肥胖儿童血中OrexinA浓度显著低于对照组浓度(P<0·01);肥胖男生T浓度显著低于对照组,肥胖女生E2、LH浓度显著高于对照组(P<0·01);男女肥胖儿童骨龄明显大于对照组,且随着骨龄的增大血中leptin,LH含量明显增加;男女肥胖与正常儿童LH与FSH之间、leptin与insulin,C-肽,E2之间均存在正相关关系(P<0·01);对照组男生LH、FSH与E2存在正相关关系(r=0·373、0·314,P<0·05);leptin与T存在负相关关系(r=-0·423)P<0·01,与FSH存在正相关关系(r=0·308,P<0·05);对照组女生leptin、LH与E2均存在正相关性(r=0·585、0·647,P<0·01);男女肥胖组LH、FSH与T,E2之间均未发现相关关系,肥胖男生leptin与T呈负相关关系(r=-0·574,P<0·01)。结论肥胖儿童相对与正常儿童血中leptin,orexina,insulin和T,E2,LH浓度发生了明显变化,肥胖儿童高浓度leptin水平可使体内T,E2,LH浓度水平发生变化,影响肥胖儿童的青春期发育。

Objective To investigate the level changes of obesity-associated factors and puberty-associated hormones and their relationship between obese and normal Children. Methods The concentrations of orexins, leptin, insulin, testosterone（T）, estradiol（E2 ）, luteotrophie hormone（LH）, as well as follicle stimulating hormone（FSH） in blood were measured respectively in 78 eases of 13 years old obesity children and 84 normal children as a control group by the means of RIA methods. The bone ages were evaluated with ＂bone age standard of hundred percent scale＂. Results The leptin and insulin concentrations were significantly higher in obesity children as compared with the control group （P 〈 0.01 ）. The concentrations of plasma orexinA were significantly lower in obesity children as compared with the control group （ P 〈 0.01）. The concentrations of T were significantly lower in obesity boys as compared with the control group （P 〈 0.01）. The concentrations of E2 and LH were significantly higher in obesity girls as compared with the control group （P 〈 0.01 ）. The bone age of the obese children was significantly older than that of the control group. Along with the bone age of children became older, the concentration of leptin and LH in blood were significantly increased. There was a positive correlation between LH and FSH in two groups of either boys and girls and so did between leptin and insulin, C-peptide, E2 （P 〈 0.01）. In the group of normal boys, the positive correlations between LH, FSH and E2 were shown（ r = 0.373, 0.314, P 〈 0.05）, and a negative correlations between leptin and T were shown as（ r = - 0.423, P 〈 0.01 ）, a positive correlation between leptin and FSH was also shown as （ r = 0. 308, P 〈 0.05 ）. In the control group of girls, there were positive correlations between leptin, LH and E2 （ r = 0.585, 0.647, P 〈 0.01）. Any correlations between LH, FSH T and E2 were not shown in the two obese groups of boys and girls. Conclusion The leptin, orexinA, insulin, T, E2 , and LH concentrations had been changed significantly in blood among those obesity children, and so as their interactions. The high level of leptin in obesity children may change the concentrations of T, E2 and LH and affect the development of puberty.