Wabitsch M, Hauner H, Heinze E, Böckmann A, Benz R, Mayer H, Teller W
Department of Pediatrics, University of Ulm, Germany.
J Clin Endocrinol Metab. 1995 Dec;80(12):3469-75. doi: 10.1210/jcem.80.12.8530585.
The aim of this study was to investigate the role of body fat distribution on steroid hormone serum concentrations in obese adolescent girls before and after weight reduction. Ninety-two girls (age, 15.1 +/- 0.7 yr) with a mean body mass index of 31.2 +/- 4.6 kg/m2 participated in this 6-week intervention study. Initially, girls with abdominal obesity (waist to hip ratio, > 0.86; n = 30) had higher levels of total and free testosterone and lower levels of sex hormone-binding globulin as well as lower morning levels of total and free cortisol than girls with gluteal-femoral obesity (waist to hip ratio, < 0.80; n = 31) independent of their body mass index. After a mean weight loss of 8.3 +/- 2.6 kg by a standardized weight loss program, significant reductions were observed in estradiol, total and free testosterone, dehydroepiandrosterone sulfate, and the ratio of LH to FSH, whereas sex hormone-binding globulin and free cortisol levels increased significantly. Decreases in total and free testosterone and increases in total and free cortisol were significantly greater in the girls with abdominal obesity than in the girls with gluteal-femoral obesity. Our results suggest that obese girls with an abdominal pattern of fat distribution exhibit more pronounced steroid hormone aberrations, in particular a high androgenic activity, than girls with a gluteal-femoral pattern of fat distribution. The reduction of excess body weight by a conventional treatment regimen is associated with a remarkable improvement of steroid hormone abnormalities in this particular subtype of obese adolescent girls.
本研究旨在调查体脂分布对肥胖青春期女孩减肥前后血清类固醇激素浓度的影响。92名平均体重指数为31.2±4.6kg/m²的女孩（年龄15.1±0.7岁）参与了这项为期6周的干预研究。最初，腹部肥胖（腰臀比>0.86；n=30）的女孩比臀股部肥胖（腰臀比<0.80；n=31）的女孩，无论其体重指数如何，总睾酮和游离睾酮水平更高，性激素结合球蛋白水平更低，早晨总皮质醇和游离皮质醇水平也更低。通过标准化减肥计划平均减重8.3±2.6kg后，雌二醇、总睾酮和游离睾酮、硫酸脱氢表雄酮以及促黄体生成素与促卵泡激素的比值均显著降低，而性激素结合球蛋白和游离皮质醇水平显著升高。腹部肥胖女孩的总睾酮和游离睾酮降低以及总皮质醇和游离皮质醇升高幅度显著大于臀股部肥胖女孩。我们的结果表明，与臀股部脂肪分布模式的女孩相比，腹部脂肪分布模式的肥胖女孩表现出更明显的类固醇激素异常，尤其是高雄激素活性。通过传统治疗方案减轻多余体重与这类肥胖青春期女孩类固醇激素异常的显著改善有关。
