瘦素在女性青春期发育中的作用

目的 探讨瘦素在女性青春期发育中的作用及其与胰岛素、生长激素、雌二醇和睾酮的相互关系。方法 2001年9月筛选7－17岁单纯性肥胖女性150人,以相互身高相差不超过2cm,年龄相差不超过3个月进行配比,选择正常组和营养不良组各150人。结果 女性血清瘦素水平与体重指数和年龄均呈正相关。女性血清瘦素水平从B1期到B5期逐步上升。正常组B2期血清瘦素水平（7.72μg/L）和营养不良组B2期（7.36μg/L)相近,但显著低于肥胖组B2期血清瘦素水平（12.85μg/L),其他各期肥胖组、正常组和营养不良组均差异有显著性。瘦素与生长激素呈负相关,与胰岛素呈强正相关,但与雄二醇和睾酮无相关性。结论 瘦素在启动女性青春期发育中可能发挥了作用。B2期瘦素水平可能是瘦素启动女性青春期发育的阈剂量。B5期瘦素水平迅速增长具有抑制生长激素分泌的作用,起到青春期发育结束信号的作用。

Roles of leptin in the development during girls'puberty

OBJECTIVES: To study the roles of leptin in the development during puberty in girls and the its relationship with insulin (INS), growth hormone (GH), estradiol (E(2)) and testosterone (T). METHODS: One hundred and fifty girls with simple obese aged 7 to 17 years, and 150 normal healthy girls and 150 girls with malnutrition matched for age (+/- 3 months) and height (+/- 2 cm) were selected. Serum levels of leptin, INS, GH, E(2) and T were measured for them. RESULTS: Their serum level of leptin positively correlated with body mass index (BMI) and age. Serum level of leptin in girls increased steadily from Tanner stage B(1) to stage B(5). At Tanner stage B(2), serum level of leptin in the normal groups (7.72 microg/L) was not significantly different from that in those with malnutrition (7.36 microg/L), but significantly lower than that in the obese groups (12.85 microg/L). At other Tanner stages, there was significant difference in serum level of leptin among obese, normal and malnutrition groups. Serum level of leptin correlated negatively with serum GH and positively with serum INS, but not correlated with E(2) and T. CONCLUSIONS: Leptin may play a role in triggering development during puberty in girls. Serum level of leptin at Tanner stage B(2) may be the threshold dose to trigger the onset of puberty in girls. Quickly increasing level of leptin at Tanner stage B(5) may inhibit the increase of GH, which ushered the end of puberty in girls.