Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.
Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado.
J Clin Endocrinol Metab. 2019 Oct 1;104(10):4390-4397. doi: 10.1210/jc.2018-02747.
Obesity is known to impact reproductive function in adults, but little is known about its effects on reproductive hormones during puberty.
To assess sex differences in effects of obesity on reproductive hormones and their relation to insulin sensitivity and secretion.
Cross-sectional study including anthropometrics, serum and urine reproductive hormone concentrations, and intravenous glucose tolerance testing (IVGTT) to assess acute insulin response to glucose (AIRg), and insulin sensitivity (Si).
Outpatient academic clinical research center.
Girls (52%) and boys (48%) who were normal weight (NW; n = 51, BMI-Z score = -0.11 ± 0.77, age = 11.5 ± 1.7 years) and obese (n = 53, BMI-Z score = 2.22 ± 0.33, age = 10.9 ± 1.5 years), Tanner stage 2 to 3.
Boys with obesity had lower total testosterone (P < 0.0001) and higher concentrations of the urinary estradiol metabolite, E1c, (P = 0.046) than boys with NW. Girls with obesity had higher free androgen index (FAI; P = 0.03) than NW girls. Both boys and girls with obesity had lower sex hormone-binding globulin (SHBG; P < 0.0001) than NW. AIRg was inversely related to SHBG in boys (R = 0.6, P < 0.0001) and girls (R = 0.53, P = 0.0001). Si correlated with higher SHBG in boys (R2 = 0.67, P < 0.0001) and girls (R = 0.5, P = 0.0003), higher total testosterone for boys (R = 0.39, P = 0.01), and lower FAI for girls (R = -0.2, P = 0.04).
Youth with obesity have lower SHBG than youth with NW, but obesity has differential effects on reproductive hormones in girls versus boys, which are apparent early in puberty. Ongoing longitudinal studies will evaluate the impact of obesity on reproductive hormones in girls and boys as puberty progresses.
肥胖已知会影响成年人的生殖功能，但对于其在青春期对生殖激素的影响知之甚少。
评估肥胖对生殖激素的影响在性别之间的差异，及其与胰岛素敏感性和分泌的关系。
包括人体测量、血清和尿液生殖激素浓度以及静脉葡萄糖耐量试验（IVGTT）以评估急性胰岛素对葡萄糖的反应（AIRg）和胰岛素敏感性（Si）的横断面研究。
门诊学术临床研究中心。
正常体重（NW；BMI-Z 评分 = -0.11 ± 0.77，年龄 = 11.5 ± 1.7 岁）和肥胖（BMI-Z 评分 = 2.22 ± 0.33，年龄 = 10.9 ± 1.5 岁）的女孩（52%）和男孩（48%），均处于 Tanner 2 至 3 期。
肥胖男孩的总睾酮（P < 0.0001）和尿液雌二醇代谢物 E1c 的浓度（P = 0.046）均低于 NW 男孩。肥胖女孩的游离雄激素指数（FAI；P = 0.03）高于 NW 女孩。肥胖男孩和女孩的性激素结合球蛋白（SHBG；P < 0.0001）均低于 NW。男孩（R = 0.6，P < 0.0001）和女孩（R = 0.53，P = 0.0001）的 AIRg 与 SHBG 呈负相关。男孩（R2 = 0.67，P < 0.0001）和女孩（R = 0.5，P = 0.0003）的 Si 与较高的 SHBG 相关，男孩的总睾酮（R = 0.39，P = 0.01）和女孩的 FAI 较低（R = -0.2，P = 0.04）。
肥胖的年轻人的 SHBG 低于 NW 的年轻人，但肥胖对女孩和男孩的生殖激素有不同的影响，在青春期早期就很明显。正在进行的纵向研究将评估肥胖对女孩和男孩青春期进展过程中生殖激素的影响。
