Baldelli Roberto, Dieguez Carlos, Casanueva Felipe F
Department of Medicine, Santiago de Compostela University and Complejo Hospitalario Universitario de Santiago, Spain.
Ann Med. 2002;34(1):5-18. doi: 10.1080/078538902317338599.
The discovery of the adipocyte-produced hormone leptin has greatly changed the field of obesity research and future treatment as well as our understanding of energy homeostasis in man. In addition to its relevant role as a metabolic adaptor to overweight and fasting states, new and previously unsuspected neuroendocrinological roles have emerged for leptin. In reproduction, leptin is implicated in fertility regulation and appears as a permissive factor for puberty. In particular, various sets of data suggest that leptin may serve as a signal to the central nervous system (CNS) with information on the critical amount of adipose tissue stores that is necessary for gonadotropin-releasing hormone (GnRH) secretion and pubertal activation of the hypothalamic-pituitary-gonadal axis. Leptin also acts at the periphery, directly on the ovary and testis where it may control steroidogenesis, although the exact role of intragonadal action in the physiology and pathophysiology of the human reproductive system needs to be further elucidated. Furthermore, relevant gender-based differences in leptin levels exist, with higher levels in women, even at birth, and which persist throughout life. In adult life, there is experimental evidence that leptin is a permissive factor for the menstrual cycle, with a regulatory role exerted at hypothalamic, pituitary and gonadal levels, and with severe changes in pregnancy and postpartum. Moreover, leptin is present in both human and commercial milk, and may play a role in the adaptive responses of the newborn.
脂肪细胞产生的激素瘦素的发现极大地改变了肥胖研究领域、未来治疗方法以及我们对人体能量平衡的理解。除了作为对超重和禁食状态的代谢适应因子所起的相关作用外，瘦素还出现了新的、此前未被怀疑的神经内分泌作用。在生殖方面，瘦素与生育调节有关，并且似乎是青春期的一个允许因子。特别是，各种数据集表明，瘦素可能作为一种信号传递给中枢神经系统（CNS），传达有关促性腺激素释放激素（GnRH）分泌以及下丘脑 - 垂体 - 性腺轴青春期激活所需的关键脂肪组织储存量的信息。瘦素也作用于外周，直接作用于卵巢和睾丸，在那里它可能控制类固醇生成，尽管性腺内作用在人类生殖系统生理和病理生理中的确切作用仍需进一步阐明。此外，瘦素水平存在基于性别的相关差异，女性的瘦素水平更高，甚至在出生时就如此，并且这种差异会持续一生。在成年期，有实验证据表明瘦素是月经周期的一个允许因子，在丘脑下部、垂体和性腺水平发挥调节作用，并且在怀孕和产后会发生严重变化。此外，瘦素存在于人类母乳和商业牛奶中，可能在新生儿的适应性反应中发挥作用。
