性早熟女童血浆ghrelin水平与腺垂体激素的关系

Relationship of plasma ghrelin and adenohypophyseal hormone levels in female precocious puberty

目的：探讨性早熟女童血浆ghrelin与腺垂体激素的关系。方法：84例年龄在6-9岁的性早熟女童根据第二性征发育情况、骨龄、子宫、卵巢容积及GnRH激发试验的结果分为特发性中枢性早熟（ICPP）和单纯乳房早发育（PT）组,采用放射免疫法测定性早熟女童空腹血浆ghrelin水平,化学发光法测定ACTH、TSH、PRL、GH、LH、FSH,并与对照组比较。结果：1ICPP组血浆ghrelin为Log（2.42±0.26）ng/L,明显低于PT组和对照组[Log（2.62±0.21）ng/L,Log（2.58±0.44）ng/L,P〈0.05];而对照组与PT组两组之间比较差异无显著性（P〉0.05）。2TannerⅢ期的ICPP女童ghrelin为Log（2.31±0.24）ng/L明显低于TannerⅡ期的ICPP女童[Log（2.53±0.24）ng/L,P〈0.05]。3经双变量相关分析,性早熟女童血浆ghrelin水平与ACTH、PRL及GnRH激发后的LH15、LH30、LH60呈负相关（r分别为-0.248、-0.235、-0.445、0.405、0.398,均P〈0.05）;而与GH、GnRH激发后的FSH15及LH0^-2、FSH0^-2无相关。结论：ICPP女童血浆ghrelin水平下降,TannerⅢ期女童血浆ghrelin低于TannerⅡ期,GnRH激发后与LH呈负相关。这可能与性启动有关。

Objective： To investigate the relationship of plasma ghrelin and adenohypophyseal hormone levels in female precocious puberty. Methods： A total of 84 patients aged from 6 to 9 years were enrolled in this study. They were divided into idiopathic central precocious puberty （ICPP） and premature thelarche （PT） groups according to their secondary sexual characteristics,bone age,volumes of uterus and ovary,and results of GnRH test. Plasma ghrelin levels were measured by radioimmunoassay. ACTH,TSH,PRL,GH,LH and FSH were measured by chemoluminescence technique. Results： Ghrelin levels in ICPP group were Log （2.42±0.26） ng/L,which were significantly lower than those in PT group and controls [Log （2.62±0.21） ng/L and Log （2.58±0.44） ng/L,respectively,P〈0.05]. However there was no significant difference between PT group and controls （P〉0.05）. Ghrelin levels of ICPP girls with Tanner Ⅲ were Log （2.31±0.24） ng/L,significantly lower than those of ICPP girls with Tanner Ⅱ [Log （2.53±0.24） ng/L,P〈0.05]. By bivariate correlation analysis,ghrelin levels in precocious puberty girls were negatively correlated with ACTH,PRL and LH15,LH30 and LH60 in GnRH test（r=-0.248,-0.235,-0.445,0.405,0.398,respectively,P〈0.05）. No significant correlation was found between ghrelin and GH,LH0-2,FSH0-2,and FSH15,FSH30 and FSH60 in GnRH test. Conclusions： ICPP girls have lower plasma ghrelin levels,which are decreased with the development of Tanner stage. The plasma ghrelin levels are negatively correlated with ACTH,PRL and LH.