Nowicki Michal, Adamkiewicz Grazyna, Bryc Wladyslaw, Kokot Franciszek
Department of Nephrology, Endocrinology and Metabolic Diseases, Silesian University School of Medicine, Polish Mother's Memorial Hospital Research Institute, Katowice, Poland.
Am J Obstet Gynecol. 2002 Mar;186(3):340-4. doi: 10.1067/mob.2002.120485.
The purpose of this study was to examine the influence of luteinizing hormone-releasing hormone analog goserelin on serum leptin and body composition in women with solitary uterine myoma.
Fifteen women who were regularly menstruating and not obese were included. In all subjects, serum concentrations of leptin, insulin, testosterone, progesterone, and estradiol and body mass index and waist-to-hip ratio were measured before and after 4, 8, and 12 weeks of treatment with goserelin (3.6 mg every 4 weeks). Fat mass and lean body mass were measured by dual energy radiographic densitometry at baseline and after 12 weeks of therapy. Data were analyzed by multiple way analysis of variance and both simple and multiple regression.
The treatment caused a significant regression of myoma. Body weight, fat, and lean mass were unchanged. No changes in plasma leptin (even after correction for fat mass) were noted during the treatment. Plasma estradiol decreased below castrate levels. Plasma progesterone decreased significantly, and testosterone tended to decline during the study. At baseline a highly significant positive correlation was found between serum leptin and fat mass. In a multiple regression analysis, neither the change in fat mass nor any of the hormonal parameters explained the significant portion of variance of plasma leptin during the treatment.
Pharmacologic gonadectomy does not influence plasma leptin concentrations in women if body fat mass is unchanged.
本研究旨在探讨促黄体生成素释放激素类似物戈舍瑞林对孤立性子宫肌瘤女性血清瘦素及身体成分的影响。
纳入15名月经规律且非肥胖的女性。对所有受试者在使用戈舍瑞林（每4周3.6毫克）治疗4周、8周和12周之前及之后，测定血清瘦素、胰岛素、睾酮、孕酮和雌二醇浓度以及体重指数和腰臀比。在基线及治疗12周后，采用双能X线骨密度仪测量脂肪量和去脂体重。数据通过多因素方差分析以及简单和多元回归进行分析。
治疗导致肌瘤显著缩小。体重、脂肪和去脂体重未发生变化。治疗期间未观察到血浆瘦素的变化（即使校正脂肪量后）。血浆雌二醇降至去势水平以下。血浆孕酮显著降低，睾酮在研究期间呈下降趋势。在基线时，血清瘦素与脂肪量之间存在高度显著的正相关。在多元回归分析中，脂肪量的变化以及任何激素参数均未解释治疗期间血浆瘦素变异的显著部分。
如果身体脂肪量不变，药物性去势对女性血浆瘦素浓度无影响。
