青春期前肥胖与正常儿童尿促性腺激素和性激素水平的比较

The comparison between prepubertal obesity and normal children's gonadotropin and gonadal steroid hormones in urine

为测定青春期前肥胖儿童尿促性腺激素和性激素,留取无锡市2个社区3～7岁(无性征发育)肥胖和正常儿童晨尿,免疫化学发光法测定黄体生成素(LH)、卵泡刺激素(FSH)、雌三醇、雌二醇、睾酮和孕酮,比较青春期前肥胖与正常儿童尿促性腺激素和性激素水平。结果表明:肥胖男、女童、正常男、女童分别有119、67、568和556例。正常男童FSH随年龄的增长呈上升趋势,女童呈下降趋势,而肥胖男、女童则均无此趋势。男童肥胖组和正常组FSH、雌三醇、雌二醇和睾酮分别为56.68 (39.99～83.89)/48.18 (30.91～71.59)mU、2.309 (1.812～3.544)/1.956 (1.487～2.567)ng、2.878(2.166～3.750)/2.534(1.964～3.291)ng、13.71 (10.42～17.61)/10.40 (7.484～14.34)ng,2组P≤0.01;肥胖女童LH、FSH、雌三醇、雌二醇和孕酮与其正常组均无统计学差异。这一研究提示肥胖男童尿促性腺激素和性激素水平均高于其正常组,肥胖可能通过影响下丘脑-垂体-性腺轴功能而引起这一变化。

By measuring urine gonadotropin and gonadal steroid hormones in prepubertal children,we aimed to compare the difference of gonadotropin and gonadal steroid hormones levels in urine between prepubertal obese and normal children.In two communities,the first morning voided urine samples were collected from prepubertal obese and normal children aged from 3 to 7 years old.Urine luteinizing hormone（LH）,follicle stimulating hormone（FSH）and gonadal steroid hormones（estriol,estradiol,testosterone and progesterone）were determined by immunochemiluminometric assay（ICMA）.Timed urine hormones contents were calculated and the results were showed as median（25 th-75 th percentile）.The results showed that there were 119,67,568 and 556 cases in obese boys,obese girls,normal boys and normal girls,respectively.With the age growing,there was an increasing trend for FSH among normal boys,and there was a declining trend among normal girls,while there was no significant trend among obese boys（or girls）.The FSH,estriol,estradiol and testosterone in obese boys were respectively 56.68（39.99-83.89）mU,2.309（1.812-3.544）ng,2.878（2.166-3.750）ng and 13.71（10.42-17.61）ng,and for normal boys were respectively 48.18（30.91-71.59）U,1.956（1.487-2.567）ng,2.534（1.964-3.291）ng and 10.40（7.484-14.34）ng,and there were significant differences for the same indicator between two obese and normal boys（all P≤0.01）.However,there were no significantdifferences in FSH,estriol,estradiol and progesterone between obese and normal girls.The levels of urine gonadotropin and gonadal steroid hormones in obese boy were higher than those in normal boy;obesity may contribute to this difference through affecting the function of HPGA.