曲普瑞林对特发性中枢性性早熟女童胰岛素敏感性影响

Effect of Triptorelin on Insulin Sensitivity in Girls with Idiopathic Central Precocious Puberty

目的:观察促性腺激素释放激素类似物(GnRHa)曲普瑞林对特发性中枢性性早熟(ICPP)女童胰岛素敏感性的影响。方法:选取44例ICPP女童给予曲普瑞林治疗12个月。观察治疗前和治疗3个月、治疗6个月、治疗12个月时患儿的身高、体重、体重指数(BMI)、骨龄、空腹血糖、空腹胰岛素和血脂水平变化,采用稳态模型胰岛素抵抗指数(HOMA-IR)评估胰岛素敏感性。结果:治疗3个月时ICPP女童身高、体重、BMI及骨龄相比治疗前无明显变化(P>0.05);治疗6个月和治疗12个月时ICPP女童身高、体重、BMI较治疗前和治疗3个月时显著增加(P<0.05),而骨龄无明显变化(P>0.05);治疗12个月时ICPP女童的身高、体重、BMI、骨龄均较治疗6个月时明显增加(P<0.05)。治疗3个月时ICPP女童空腹血糖、空腹胰岛素、HOMA-IR与治疗前无明显变化(P>0.05);治疗6个月和治疗12个月时ICPP女童空腹血糖、空腹胰岛素、HOMA-IR均显著高于治疗前和治疗3个月(P<0.05),而治疗6个月和治疗12个月比较,差异无统计学意义(P>0.05)。患儿的血脂水平在整个观察期均无明显变化(P>0.05)。ICPP女童HOMA-IR增加与BMI增加无明显相关性。结论:曲普瑞林治疗可降低ICPP女童的胰岛素敏感性。

Objective:To observe the effect of gonadotropin-releasing hormone analog(GnRHa)triptorelin on insulin sensitivity in girls with idiopathic central precocious puberty(ICPP).Methods:Forty-four ICPP girls were enrolled in the study and given triptorelin for 12 months.The height,weight,BMI,bone age,fasting blood glucose(FBG),fasting insulin(FINS)and blood lipid were determined before and the end of third month,6 th month and 12 th month.Insulin sensitivity was estimated by homeostasis model assessment of insulin resistance(HOMA-IR).Results:The height,weight,BMI and bone age of ICPP girls did not change significantly at 3 rd months after treatment(P>0.05);the height,weight and BMI of ICPP girls increased significantly at 6 th month and 12 th month after treatment,than those before treatment and 3 rd month after treatment(P<0.05),but there was no significant change in bone age(P>0.05);at 12 th month after treatment,the height,weight,BMI and bone age of ICPP girls increased significantly than 6 th month after treatment(P>0.05).The FBG,FINS and HOMA-IR of ICPP girls did not change significantly at 3 rd month after treatment(P>0.05),while those indicators at 6 th month and 12 th month after treatment were higher than those before treatment and 3 rd month after treatment(P<0.05),but there was no significant difference between 6 th month after treatment and 12 th month after treatment(P>0.05).The blood lipid level had no significant change during the whole observation period(P>0.05).There was no significant correlation between the increase of HOMA-IR and BMI in ICPP girls.Conclusion:Triptorelin may lead to decrease of insulin sensitivity in ICPP girls.