Yoo Jae Won, Song Chun Woo, Lim Han Hyuk
Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, Korea.
Ann Pediatr Endocrinol Metab. 2016 Dec;21(4):199-205. doi: 10.6065/apem.2016.21.4.199. Epub 2016 Dec 31.
The effects of gonadotropin-releasing hormone agonist (GnRHa) treatment on the energy metabolism in girls with central precocious puberty (CPP) are controversial. We focused the changes and related factors of serum levels of leptin and adiponectin in girls with CPP before and during GnRHa treatment.
Thirty girls with idiopathic CPP were enrolled in the study. Their auxological data and fasting blood were collected at the baseline and after six months of GnRHa treatment.
After treatment, height (<0.001), weight (<0.001), and serum leptin levels (=0.033) were significantly increased, whereas body mass index (BMI), homeostasis model of assessment-insulin resistance, serum adiponectin levels, and adiponectin/leptin ratio exhibited no significant changes. A Pearson correlation analysis showed that height, weight, BMI, and their standard deviation scores (SDSs), but not basal LH, FSH, and estradiol, were significantly correlated with serum leptin levels before and after GnRHa treatment. After a multiple linear regression analysis, only BMI was associated with serum leptin levels. Moreover, leptin SDSs adjusted for BMI were not significantly different before and after GnRHa. The Δ leptin levels (=0.207, =0.012), but not with Δ leptin SDS (=0.019, =0.556), during GnRHa treatment were positively correlated with Δ BMI.
These results suggest that GnRHa treatment in girls with CPP does not affect serum levels of leptin and adiponectin and insulin resistance. Serum leptin levels were depend on the changes in BMI during GnRHa treatment.
促性腺激素释放激素激动剂(GnRHa)治疗对中枢性性早熟(CPP)女童能量代谢的影响存在争议。我们重点研究了CPP女童在GnRHa治疗前及治疗期间血清瘦素和脂联素水平的变化及相关因素。
30例特发性CPP女童纳入本研究。在基线期及GnRHa治疗6个月后收集她们的体格学数据和空腹血样。
治疗后,身高(<0.001)、体重(<0.001)和血清瘦素水平(=0.033)显著升高,而体重指数(BMI)、稳态模型评估-胰岛素抵抗、血清脂联素水平及脂联素/瘦素比值无显著变化。Pearson相关分析显示,身高、体重、BMI及其标准差评分(SDS),而非基础促黄体生成素(LH)、促卵泡生成素(FSH)和雌二醇,在GnRHa治疗前后与血清瘦素水平显著相关。多元线性回归分析后,仅BMI与血清瘦素水平相关。此外,经BMI校正的瘦素SDS在GnRHa治疗前后无显著差异。GnRHa治疗期间,Δ瘦素水平(=0.207,=0.012)与ΔBMI呈正相关,而Δ瘦素SDS(=0.019,=0.556)与ΔBMI无相关性。
这些结果表明,GnRHa治疗CPP女童不影响血清瘦素、脂联素水平及胰岛素抵抗。血清瘦素水平取决于GnRHa治疗期间BMI的变化。