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特纳综合征和克莱恩费尔特综合征患者性激素治疗对循环脂联素及其亚型的影响。

Effect of sex hormone treatment on circulating adiponectin and subforms in Turner and Klinefelter syndrome.

机构信息

Medical Department M, Diabetes and Endocrinology and the Medical Research Laboratories, Clinical Institute, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.

出版信息

Eur J Clin Invest. 2010 Mar;40(3):211-9. doi: 10.1111/j.1365-2362.2009.02250.x. Epub 2010 Jan 22.

Abstract

BACKGROUND

Sex hormones have been shown to influence levels of adiponectin. Furthermore, testosterone has been shown to alter the subform distribution of adiponectin, whereas the effects of oestradiol are equivocal. We investigated the impact of sex hormone replacement therapy (HRT) on circulating adiponectin and its subforms, fasting lipids and measures of insulin sensitivity in Turner syndrome (TS) and Klinefelter syndrome (KS) respectively.

MATERIALS AND METHODS

We compared eight young TS patients on and off 2 months of HRT vs. eight age- and body mass index (BMI) matched healthy females as well as 19 untreated KS patients vs. 20 testosterone treated KS patients vs. 20 age and BMI matched healthy males. Total adiponectin and adiponectin subforms separated by fast protein liquid chromatography were measured using an in-house assay. In addition, fasting levels of insulin, glucose and homeostasis model assessment estimates were determined.

RESULTS

In TS, total adiponectin levels were 10.5 +/- 3.1 (mean +/- SD) vs. 12.8 +/- 3.5 mg L(-1) (P = 0.02) and high molecular weight (HMW) adiponectin 5.8 +/- 2.7 and 6.8 +/- 1.9 mg L(-1) (P = 0.02) on and off HRT respectively. Irrespective of HRT, total adiponectin and HMW adiponectin were similar to control values. In KS, total adiponectin levels were 6.5 (3.0-24.2) (median and range) and 9.3 (4.3-14.3) mg L(-1) (P = NS) and HMW adiponectin was 2.5 (0.5-16.0) and 4.6 (1.3-8.6) mg L(-1) (P = NS) with and without testosterone treatment respectively, and similar to controls.

CONCLUSION

Short time HRT suppressed HMW and total adiponectin levels in TS patients. Testosterone treatment in KS patients had no effect on these parameters. In both groups of patients either adiponectin or the HMW subform seems to play no greater role in reflecting or mediating insulin sensitivity. Our data indicates that in patients with TS and KS, sex hormones have different effects on circulating adiponectin and its HMW subform than previously reported in other sex hormone deficient patients and healthy subjects.

摘要

背景

性激素已被证明会影响脂联素水平。此外,睾酮已被证明会改变脂联素的亚基分布,而雌二醇的作用则存在争议。我们分别研究了特纳综合征(TS)和克氏综合征(KS)患者的性激素替代治疗(HRT)对循环脂联素及其亚基、空腹血脂和胰岛素敏感性的影响。

材料与方法

我们比较了 8 名接受 2 个月 HRT 的年轻 TS 患者和 8 名年龄和体重指数(BMI)匹配的健康女性,以及 19 名未接受治疗的 KS 患者、20 名接受睾酮治疗的 KS 患者和 20 名年龄和 BMI 匹配的健康男性。使用内部检测方法测量总脂联素和通过快速蛋白质液体色谱分离的脂联素亚基。此外,还测定了空腹胰岛素、葡萄糖和稳态模型评估的水平。

结果

在 TS 中,总脂联素水平分别为 10.5±3.1(平均值±标准差)和 12.8±3.5mg/L(P=0.02),高分子量(HMW)脂联素分别为 5.8±2.7 和 6.8±1.9mg/L(P=0.02),在接受 HRT 和不接受 HRT 时。无论是否接受 HRT,总脂联素和 HMW 脂联素均与对照值相似。在 KS 中,总脂联素水平分别为 6.5(3.0-24.2)(中位数和范围)和 9.3(4.3-14.3)mg/L(P=NS),HMW 脂联素分别为 2.5(0.5-16.0)和 4.6(1.3-8.6)mg/L(P=NS),接受和不接受睾酮治疗时,均与对照组相似。

结论

短期 HRT 抑制了 TS 患者的 HMW 和总脂联素水平。KS 患者的睾酮治疗对这些参数没有影响。在这两组患者中,脂联素或 HMW 亚基似乎都没有更大的作用来反映或调节胰岛素敏感性。我们的数据表明,在 TS 和 KS 患者中,性激素对循环脂联素及其 HMW 亚基的影响与以前在其他性激素缺乏患者和健康受试者中报道的不同。

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