Kilciler Guldem, Ozata Metin, Oktenli Cagatay, Sanisoglu S Yavuz, Bolu Erol, Bingol Necati, Kilciler Mete, Ozdemir I Caglayan, Kutlu Mustafa
Department of Endocrinology and Metabolism, Gulhane School of Medicine, TR 06018 Etlik-Ankara, Turkey 06018.
J Clin Endocrinol Metab. 2002 Nov;87(11):5023-9. doi: 10.1210/jc.2002-020516.
Circulating leptin shows a pulsatile secretory pattern along with a nocturnal rise. We have previously shown that circulating leptin concentrations are high in males with untreated idiopathic hypogonadotropic hypogonadism (IHH). However, circadian leptin secretion in IHH before and after gonadotropin treatment is not known. Thus, we studied 14 adult males with IHH who had no history of previous hormonal therapy, and 12 age- and body mass index-matched healthy men. Plasma leptin concentrations were measured with 1-h intervals for 24 h before and 6 months after gonadotropin treatment. The 24-h mean leptin concentration showed a significant decrease, from 11.78 +/- 1.908 microg/liter at baseline to 10.85 +/- 1.939 microg/liter after 6 months of therapy (z = 3.107; P = 0.002). Before and after treatment, 24-h mean leptin concentrations were also significantly higher in the patient group when compared with controls (4.275 +/- 0.711 microg/liter) (z = 5.938; P = 0.0001). Hourly leptin levels demonstrated a diurnal pattern in hypogonadal patients, a surge in the midday, and a peak just after midnight, and this pattern did not differ before and after treatment. We observed a similar diurnal pattern in the control subjects too. Leptin levels were negatively and significantly correlated with free testosterone and total testosterone levels both before (r = -0.656, P = 0.011; and r = -0.639, P = 0.014, respectively) and after (r = -0.537, P = 0.048; and r = -0.563, P = 0.036, respectively) gonadotropin administration. Our observations suggest that the diurnal rhythm of leptin is intact in males with IHH, and short-term gonadotropin treatment does not effect its diurnal rhythm. Moreover, testosterone produced under the influence of the gonadotropin treatment led to decreases in the leptin levels.
循环中的瘦素呈现出脉冲式分泌模式以及夜间升高的现象。我们之前已经表明，未经治疗的特发性低促性腺激素性性腺功能减退症（IHH）男性患者的循环瘦素浓度较高。然而，在促性腺激素治疗前后，IHH患者的昼夜瘦素分泌情况尚不清楚。因此，我们研究了14名既往无激素治疗史的成年IHH男性患者以及12名年龄和体重指数相匹配的健康男性。在促性腺激素治疗前24小时和治疗后6个月，每隔1小时测量血浆瘦素浓度。24小时平均瘦素浓度显著下降，从基线时的11.78±1.908微克/升降至治疗6个月后的10.85±1.939微克/升（z = 3.107；P = 0.002）。与对照组（4.275±0.711微克/升）相比，治疗前后患者组的24小时平均瘦素浓度也显著更高（z = 5.938；P = 0.0001）。每小时的瘦素水平在性腺功能减退患者中呈现出昼夜模式，中午有一个高峰，午夜刚过有一个峰值，并且这种模式在治疗前后没有差异。我们在对照组中也观察到了类似的昼夜模式。瘦素水平在促性腺激素给药前（分别为r = -0.656，P = 0.011；r = -0.639，P = 0.014）和给药后（分别为r = -0.537，P = 0.048；r = -0.563，P = 0.036）均与游离睾酮和总睾酮水平呈显著负相关。我们的观察结果表明，IHH男性患者的瘦素昼夜节律是完整的，短期促性腺激素治疗不会影响其昼夜节律。此外，促性腺激素治疗影响下产生的睾酮导致瘦素水平下降。
