Brabant G, Horn R, Mayr B, von zur Mühlen A, Honegger J, Buchfelder M
Abt. Klinische Endokrinologie, Medizinische Hochschule, Hannover, Germany.
Horm Metab Res. 1996 Dec;28(12):728-31. doi: 10.1055/s-2007-979888.
To study a potential alteration of hypothalamic centers involved in the negative feedback action of leptin on body weight, serum leptin levels were measured in relation to BMI in 18 patients following surgery for a hypothalamic craniopharyngioma (Ctx), and were compared to levels found in 21 patients operated for a pituitary adenoma (Ptx) or in healthy control subjects. All subjects with Ptx received rhGH replacement therapy (0.5 to 2 IU/m2/d), and serum leptin levels were followed in 3 months intervals over 24 months. Serum leptin levels in patients with Ptx were comparable to controls, whereas 7 of the 18 patients with Ctx had higher than expected concentrations for their BMI. GH treatment in Ptx subjects did not alter serum leptin levels. In 5 Ctx patients where preoperative samples were available, weight gain in parallel to an increase in serum leptin levels was observed but only minimal changes in 4 others. Our data support the role of leptin as an important marker of body weight. The rapid increase in serum leptin levels observed in some Ctx subjects suggests that early postoperative measurement of serum leptin levels may help to identify patients at risk of weight gain following hypothalamic destruction.
为研究参与瘦素对体重负反馈作用的下丘脑中心的潜在改变，我们测定了18例下丘脑颅咽管瘤（Ctx）手术后患者的血清瘦素水平，并将其与体重指数（BMI）相关联，同时与21例垂体腺瘤（Ptx）手术患者及健康对照者的血清瘦素水平进行比较。所有Ptx患者均接受重组人生长激素（rhGH）替代治疗（0.5至2 IU/m²/d），并在24个月内每隔3个月监测血清瘦素水平。Ptx患者的血清瘦素水平与对照组相当，而18例Ctx患者中有7例的血清瘦素浓度高于其BMI预期值。Ptx患者接受GH治疗并未改变血清瘦素水平。在5例有术前样本的Ctx患者中，观察到体重增加与血清瘦素水平升高平行，但其他4例仅有微小变化。我们的数据支持瘦素作为体重重要标志物的作用。在一些Ctx患者中观察到血清瘦素水平迅速升高，这表明术后早期测定血清瘦素水平可能有助于识别下丘脑破坏后有体重增加风险的患者。
