Kishi Megumi, Ohki Yukashi, Orimo Hiromi
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
Clin Pediatr Endocrinol. 2006;15(1):35-9. doi: 10.1297/cpe.15.35. Epub 2006 Feb 22.
Interactions between GH and leptin have been extensively studied. However, results of long-term GH therapy on serum leptin levels in GH-deficient children were not consistent. Moreover, no such reports were available in Japanese children with this disease. We studied 35 Japanese patients with GH deficiency (26 boys and 9 girls, mean age: 9.8 ± 6.2 yr old), of whom 6 patients with complete and 29 with incomplete GH deficiency were identified by GH provocation test. Serum leptin levels, percent of ideal body weight (%IBW) and percent fat (%fat) were determined at 0, 1, 3, 6, 12, 18, 24, and 36 mo after beginning GH therapy. Baseline levels of %fat and leptin were significantly higher in girls than boys (P<0.05), though serum leptin did not change throughout the study period in either group. Further, %IBW did not change significantly, whereas %fat exhibited significant changes after 6 mo in boys and remained virtually constant thereafter for up to 3 yr. In summary, serum leptin levels did not change in GH-deficient boys and girls during the 3-yr period after the start of GH replacement therapy, despite a decrease in %fat after 6 mo of therapy in the boys. Thus, it is conceivable that long-term GH replacement therapy can be employed without an effect on normal leptin secretion.
生长激素(GH)与瘦素之间的相互作用已得到广泛研究。然而,关于生长激素缺乏症儿童长期接受生长激素治疗后血清瘦素水平的研究结果并不一致。此外,尚无针对日本患此病儿童的此类报道。我们研究了35例日本生长激素缺乏症患者(26名男孩和9名女孩,平均年龄:9.8±6.2岁),通过生长激素激发试验确定其中6例为完全性生长激素缺乏,29例为不完全性生长激素缺乏。在开始生长激素治疗后的0、1、3、6、12、18、24和36个月测定血清瘦素水平、理想体重百分比(%IBW)和体脂百分比(%fat)。女孩的%fat和瘦素基线水平显著高于男孩(P<0.05),尽管两组在整个研究期间血清瘦素均未发生变化。此外,%IBW无显著变化,而男孩在6个月后%fat出现显著变化,此后直至3年基本保持稳定。总之,在生长激素替代治疗开始后的3年期间,生长激素缺乏的男孩和女孩血清瘦素水平均未改变,尽管男孩在治疗6个月后%fat有所下降。因此,可以设想长期使用生长激素替代治疗不会影响正常的瘦素分泌。