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双侧卵巢切除和雌激素替代疗法对血清瘦素、性激素结合球蛋白和胰岛素样生长因子-I 水平的影响。

Effects of bilateral ovariectomy and estrogen replacement therapy on serum leptin, sex hormone binding globulin and insulin like growth factor-I levels.

机构信息

Department of Endocrinology and Metabolism, Baskent University Faculty of Medicine, Ankara, Turkey.

出版信息

Gynecol Endocrinol. 2009 Dec;25(12):773-8. doi: 10.3109/09513590903159532.

Abstract

Studies evaluating the effect of estrogen replacement therapy (ERT) on leptin levels are contradictory. The aim of this study was to investigate effects of bilateral ovariectomy and ERT on serum leptin levels and anthropometric measurements as well as interaction among leptin, sex hormone binding globulin (SHBG), and insulin like growth factor-I (IGF-I) in premenopausal women after bilateral ovariectomy. Twenty-four premenopausal women who undergo bilateral overiectomy were divided into two groups based on whether they received hormonal treatment postoperatively. The studied parameters were evaluated in both groups preoperatively and during the fourth and eighth weeks postoperatively. Serum leptin, testosterone, prolactin, insulin, IGF-1 levels, BMI, HOMA-IR, and waist-to-hip ratio values did not change in both groups at all times. In the estradiol group, serum SHBG concentrations were significantly higher on weeks 8 compared with control group and basal values (p = 0.03 and 0.014, respectively). Leptin levels showed a positive linear correlation with BMI in all groups and at all times evaluated (r = 0.80, p < 0.01 for controls and r = 0.62, p < 0.01 for women treated with 17beta-estradiol) and with insulin in estradiol group on weeks 4 (r = 0.755, p < 0.05). No correlation was found between leptin and estradiol, testosterone, prolactin, SHBG, IGF-1 levels, and anthropometric variables at all times. Leptin levels do not show modification 8 weeks after bilateral ovariectomy and under ERT, suggesting that estrogens do not have a stimulatory action on leptin in humans. Although needing confirmation by a longer study, our findings suggest that IGF-I system and SHBG did not regulate leptin and vice versa and ERT do not have any effect on leptin, SHBG, and IGF-I.

摘要

研究评估雌激素替代疗法(ERT)对瘦素水平的影响是矛盾的。本研究的目的是研究双侧卵巢切除和 ERT 对血清瘦素水平和人体测量学指标的影响,以及双侧卵巢切除后绝经前妇女瘦素、性激素结合球蛋白(SHBG)和胰岛素样生长因子-I(IGF-I)之间的相互作用。24 例接受双侧卵巢切除术的绝经前妇女根据术后是否接受激素治疗分为两组。两组患者均在术前及术后第 4、8 周评估研究参数。两组患者的血清瘦素、睾丸酮、催乳素、胰岛素、IGF-1 水平、BMI、HOMA-IR 和腰臀比在各时间点均无变化。在雌二醇组,第 8 周时血清 SHBG 浓度明显高于对照组和基础值(p = 0.03 和 0.014)。在所有组和所有评估时间,瘦素水平与 BMI 呈正线性相关(对照组 r = 0.80,p < 0.01;雌二醇治疗组 r = 0.62,p < 0.01),与第 4 周雌二醇组的胰岛素呈正线性相关(r = 0.755,p < 0.05)。在所有时间点,瘦素与雌二醇、睾丸酮、催乳素、SHBG、IGF-1 水平和人体测量学变量之间均无相关性。双侧卵巢切除术后 8 周及 ERT 下,瘦素水平无变化,提示雌激素对人类瘦素无刺激作用。尽管需要更长时间的研究来证实,但我们的研究结果表明,IGF-I 系统和 SHBG 并未调节瘦素,反之亦然,ERT 对瘦素、SHBG 和 IGF-I 均无影响。

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