中枢性性早熟女童体重指数与性激素及瘦素、脂联素水平的相关性研究

Correlative study on body mass index with sex hormone,leptin and adiponectin in girls with central precocious puberty

目的研究体重指数对中枢性性早熟女童血清性激素、瘦素(leptin)、脂联素(APN)水平的影响,为临床精确分析GnRHa激发试验结果并阐述瘦素、APN在肥胖儿童青春发育中可能的作用机制。方法选取苏州大学附属张家港医院2016-2018年完成促性腺激素释放激素类似物(GnRHa)激发试验的特发性中枢性性早熟女童90例,根据体重指数(BMI)分为正常体重组(n=40)、超重组(n=30)、肥胖组(n=20),检测血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、睾酮(T)、瘦素、APN水平,并运用Spearman相关分析分析BMI与各激素水平的相关性。结果超重组和肥胖组LH峰值和APN均显著低于正常组(P<0.05),且肥胖组LH峰值和APN也显著低于超重组(P<0.05)。超重组和肥胖组瘦素均显著高于正常组(P<0.05),且肥胖组瘦素也显著高于超重组(P<0.05)。BMI与E2、T、瘦素水平呈正相关(r=0.213,0.250,0.484,P<0.05),与LH峰值、APN水平呈负相关(r=-0.417,-0.525,P<0.05)。结论在分析中枢性性早熟女童GnRHa激发试验结果及相关激素水平时需充分考虑BMI对结果的影响。

Objective To investigate the effects of body mass index(BMI)on serum levels of sex hormones,leptin and adiponectin(APN)in girls with central precocious puberty,in order to provide reference for appropriately analyzing GnRHa test result and illustrating the possible mechanism of leptin and adiponectin in adolescent development of obese children.Methods Totally 90 cases of idiopathic central precocious puberty girls who completed the gonadotropin-releasing hormone analogue(GnRHa)test in the Affiliated Zhangjiagang Hospital of Soochow University from 2016 to 2018 were selected.According to body mass index(BMI),the participants were divided into normal weight group(n=40),overweight group(n=30)and obesity group(n=20).Serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),leptin,APN were tested.The correlations between BMI and various hormone levels were analyzed by Spearman correlation analysis.Results The peaks of LH and APN in the overweight and obesity groups were significantly lower than those in the normal group(P<0.05),which was also significantly lower in obesity group than those in overweight group(P<0.05).The leptin level in the overweight group and obesity group was significantly higher than that in normal group(P<0.05).Moreover,obesity group had significantly higher levels of leptin than overweight group(P<0.05).There were positive correlations between BMI and E2,T and leptin levels(r=0.213,0.250,0.484,P<0.05),and had negative correlations with LH peak and APN levels(r=-0.417,-0.525,P<0.05).Conclusion It is supposed to take BMI into account when analyzing the result of the GnRHa agonist test and the levels of obesity-related hormones in girls with precocious puberty.