中枢性性早熟女童采用促性腺激素释放激素类似物治疗前后血清瘦素、脂联素、性激素水平变化及其相关性研究

Correlation between changes in serum leptin,adiponectin and sex hormone levels before and after GnRHa treatment in girls with central precocious puberty

目的研究中枢性性早熟(CPP)女童采用促性腺激素释放激素类似物(GnRHa)治疗前后血清中瘦素、脂联素、胰岛素、性激素水平变化及其相关性。方法选取2017年8月至2019年8月郴州市第一人民医院诊治的60例CPP女童作为研究对象,按照随机数字表法分为对照组(n=30)和GnRHa组(n=30)。对照组采用重组人生长激素治疗,GnRHa组采用注射用醋酸亮丙瑞林治疗。观察两组治疗前和治疗6个月后女童身高、体重、骨龄、空腹血糖、空腹胰岛素,以及血清瘦素、脂联素及性激素等相关指标,并运用Spearman检验和多元线性回归分析瘦素、脂联素与临床指标间的相关性。结果与治疗前比较,GnRHa组和对照组治疗6个月后身高、体重及血清瘦素水平均显著增加(P<0.05),而体重指数(BMI)、胰岛素抵抗水平、血清脂联素水平及脂联素/瘦素比例变化不明显(P>0.05)。多元线性回归分析显示,BMI是影响血清瘦素水平的显著因素,BMI变化与血清瘦素水平变化呈正相关(P<0.05)。结论GnRHa治疗CPP女童不会影响血清瘦素、脂联素和胰岛素水平,血清瘦素水平仅与BMI变化相关。

Objective To study the changes in serum levels of leptin,adiponectin,insulin,and sex hormones and their correlations before and after the treatment of central precocious puberty(CPP)with gonadotropin releasing hormone analogues(GnRHa).Methods 60 CPP girls treated in Chenzhou First People's Hospital from August 2017 to August 2019 were selected,and divided into control group(n=30)and GnRHa group(n=30)according to random number table method.The control group was treated with recombinant human growth hormone,and the GnRHa group was treated with leproteroline acetate for injection.Height,weight,bone age,fasting blood glucose,fasting insulin,serum leptin,adiponectin and sex hormones were observed before and after 6 months of treatment in the two groups.Spearman test and multiple linear regression were used to analyze the correlation between serum leptin,adiponectin and clinical indexes.Results After 6 months of treatment,height,body weight and serum leptin level in GnRHa group and control group were significantly increased(P<0.05),while body mass index(BMI),insulin resistance level,serum adiponectin level and adiponectin/leptin ratio were not significantly changed(P>0.05).Multiple linear regression analysis showed that BMI was a significant factor affecting serum leptin level,and the change of BMI was positively correlated with the change of serum leptin level(P<0.05).Conclusions GnRHa treatment of CPP girls does not affect the serum leptin,serum adiponectin and insulin levels,and the serum leptin levels are only associated with BMI changes.