Baldelli R, Durante C, D'Amico E, Diacono F, Tamburrano G, Casanueva F F
Department of Clinical Sciences, Endocrinology Section, First School of Medicine, University of Rome La Sapienza, Rome, Italy.
J Endocrinol Invest. 2003 Dec;26(12):1219-24. doi: 10.1007/BF03349161.
GH excess is characterized by alterations of body composition such as decreased body fat mass; however, scant data are present regarding its effect on serum leptin levels. To better elucidate this topic, leptin secretion was studied in 20 acromegalic patients, before and after 6 months of treatment with somatostatin analogs (SR-lanreotide 30 mg and octreotide LAR). Basal GH, IGF-I, insulin, blood glucose and lipid levels were measured and the area under the curve (AUC) for insulin and glucose and oral glucose insulin sensitivity (OGIS) during oral glucose tolerance test (OGTT) were calculated. After 6 months of somatostatin analogs therapy, a significant reduction in GH and IGF-I plasma levels was observed (p<0.0005, both) with a significant increase of leptin levels (7.4+/-1.3 vs 13.2+/-1.6 ng/ml; p<0.05). Interestingly, the typical correlation of leptin with body mass index (BMI) was not present in active acromegaly, whereas it was restored after somatostatin analogs treatment; moreover, the gender difference in leptin secretion between men and women was preserved in active and controlled acromegaly. In conclusion, the gender-based leptin differences are preserved and leptin secretion/BMI ratio is normalized in acromegalic patients after somatostatin analogs therapy.
生长激素（GH）分泌过多的特征是身体成分改变，如体脂量减少；然而，关于其对血清瘦素水平影响的数据却很少。为了更好地阐明这一主题，我们对20例肢端肥大症患者在使用生长抑素类似物（司美格鲁肽30mg和长效奥曲肽）治疗6个月前后的瘦素分泌情况进行了研究。测量了基础GH、胰岛素样生长因子-I（IGF-I）、胰岛素、血糖和血脂水平，并计算了口服葡萄糖耐量试验（OGTT）期间胰岛素和葡萄糖的曲线下面积（AUC）以及口服葡萄糖胰岛素敏感性（OGIS）。生长抑素类似物治疗6个月后，观察到GH和IGF-I血浆水平显著降低（均为p<0.0005），同时瘦素水平显著升高（7.4±1.3 vs 13.2±1.6 ng/ml；p<0.05）。有趣的是，在活动性肢端肥大症中，瘦素与体重指数（BMI）之间不存在典型的相关性，而在生长抑素类似物治疗后这种相关性得以恢复；此外，在活动性和得到控制的肢端肥大症中，男女之间瘦素分泌的性别差异仍然存在。总之，在生长抑素类似物治疗后，肢端肥大症患者基于性别的瘦素差异得以保留，且瘦素分泌/BMI比值恢复正常。
