老年男性肥胖患者性激素及其受体的变化

 目的 研究老年男性肥胖患者的性激素及其受体水平的变化,探讨性激素及其受体与肥胖的关系.方法 共调查老年(≥60岁)男性314例.其中健康人104例,年龄62～92岁,平均(71.38±5.15)岁;肥胖者74例,61～87岁,平均(71.32±4.74)岁.超重者111例,年龄60～85岁,平均(71.43±5.03)岁,采集其晨起静脉血,低温离心后取血清,测定总睾酮(TT)、游离睾酮(FT)、脱氢表雄酮硫酸酯(DHEAS)、性激素结合球蛋白(SHBG)、雌二醇(E2)、黄体生成素(LH)、卵泡刺激素(FSH)水平,并采用流式细胞术检测外周血白细胞雄激素受体(AR).结果 (1)肥胖人群TT、SHBG均值低于非肥胖人群,E2/TT则高于非肥胖人群;(2)BMI与TT、SHBG、HDL呈负相关.结论 肥胖人群的睾酮较非肥胖者明显降低,且睾酮与肥胖程度、血糖和血脂都有相关性,在肥胖的发展中起保护性作用.     

肥胖症者内分泌功能的变化

笔者观察了单纯性肥胖症及非肥胖者血清瘦素水平及其与胰岛素 (ＩＮＳ)、睾酮 (Ｔ)、泌乳素 (ＰＲＬ)、生长激素 (ＧＨ)、卵泡刺激素 (ＦＳＨ)、黄体生成素 (ＬＨ)等的相关性 ,以探讨瘦素与内分泌功能的变化。一、资料与方法1.临床资料。对照组 40例 ,男 30例 ,年龄 (35 .83± 9.6 3)岁 ,女ｌ0例 ,年龄(35± 9.76 )岁。肥胖组 48例 ,男 42例 ,年龄 (4ｌ± 9.6 8)岁 ,女 6例 ,年龄 (4 0 .5±9.42 )岁 ,体重指数≥ 2 5ｋｇ/ｃｍ2 。2 .仪器和方法。人血清瘦素用ＥＬＩＳＡ法检测 ,所用仪器为伯乐 5 5 0型酶标仪。ＩＮＳ、Ｔ、雌二醇 (Ｅ2 )、…     

飞行训练对飞行学员下丘脑-垂体-性腺轴功能的影响

目的 探讨飞行训练对飞行学员下丘脑－垂体－性腺轴功能的影响。方法 采用放射免疫法检测飞行基础学校毕业学员（１４０名）和飞行学院完成初教机（８２名）、高教机（２９名）训练阶段的学员的血清雌二醇、睾酮、催乳素、卵泡刺激素和黄体生成素５项指标。选择２０名场站地面战士作为对照组。结果 ①各学员组雌二醇、睾酮、催乳素、黄体生成素、卵泡刺激素和雌二醇／睾酮比值较对照组有不同程度改变;②其中尤以雌二醇、睾酮和雌二醇／睾酮比值改变明显;③各学员组自身比较结果显示,随着飞行时间的延长和训练强度的增大,飞行学员性激素水平的变化较大。结论 飞行训练对飞行学员下丘脑－垂体－性腺轴性激素分泌水平有一定影响,飞行因素引起的性激素失衡可能与飞行人员常见病的发生相关。     

吗啡成瘾者戒除前后血清吗啡及垂体－性腺激素浓度的变化

吗啡成瘾者戒除前后血清吗啡及垂体－性腺激素浓度的变化肖华龙，俞惠英，殷政芳，朱亚妮为了解吗啡对垂体－性腺激素的影响．用放射免疫分析法（ＲＩＡ）测定了２５例男性吗啡成瘾者戒除前后血清睾酮（Ｔ）、雌二醇（Ｅ２）、孕酮（Ｐ）、黄体生成素（ＬＨ）及卵泡刺激素...     

多囊卵巢综合征患者肾上腺雄激素水平与胰岛素抵抗的关系

目的 探讨多囊卵巢综合征(PCOS)患者肾上腺源性雄激素水平与胰岛素抵抗的关系.方法 对22名正常女性和85例PCOS患者行促肾上腺皮质激素(ACTH)兴奋试验,将PCOS患者分为高反应组(HR-PCOS)和正常反应组(NR-PCOS).用放射免疫分析法检测血清促黄体生成素与卵泡刺激素(LH/FSH)比值、雌二醇、睾酮...     

罗格列酮治疗多囊卵巢综合征胰岛素抵抗临床研究

目的研究罗格列酮对多囊卵巢综合征（PCOS）患者高胰岛素血症的疗效,观察患者治疗前后生殖激素的变化以及有排卵月经的恢复情况。方法选择诊断为多囊卵巢综合征及空腹血胰岛素≥15.6uIU/ml的患者30例,每天早餐前口服罗格列酮4mg,共12周,比较治疗前后体重指数、腰臀围比、胰岛素水平、血糖、胰岛素抵抗指数、生殖激素水平和排卵率的变化。结果治疗12周后,基础胰岛素、空腹血糖、餐后2小时血糖、胰岛素抵抗指数、睾酮、黄体生成素、黄体生成素/卵泡刺激素比值显著降低,性激素结合球蛋白显著增高。结论罗格列酮可增强胰岛素敏感性,纠正糖代谢异常和高雄激素血症等内分泌紊乱,促进有排卵月经的恢复。     

甲福明改善对氯米芬抵抗的多囊卵巢综合征病人的排卵

目的 探讨氯米芬抵抗的多囊卵巢综合征病人胰岛素增敏剂甲福明对其激素及排卵的影响。方法 选择23例经氯米芬促排卵3个月（达150mg/d)无排卵的多囊卵巢综合征病人，应用甲福明每次500mg,3/d，连续用药1个月后，观察体重、血压、血糖、胰岛素、泌乳素、卵泡刺激素、卵泡刺激素、黄体生成素、雄烯二酮、睾酮、17－羟孕酮的变化，第二周期开始氯米芬促排卵，监测排卵及妊娠情况。结果 用药后空腹和糖负荷后的胰岛素水平、雄烯乙酮、睾酮、17－羟孕酮水平均明显下降，但血糖、体重、血压、泌乳素、卵泡刺激素和雄二醇均无明显变化，黄体生成素和黄体生成素／卵泡刺激素值有所减少，但无显著差异；23例中19例983.4%)有成熟卵泡发育，16例（69.6%)有排卵，2例（8.7%)妊娠。结论 甲福明能降低氯米芬抵抗多囊卵巢综合征病人的胰岛素、雄激素水平同时，改善氯米芬的促排卵。     

游离睾酮指数及Irisin对多囊卵巢综合征不孕患者体外受精-胚胎移植治疗妊娠结局预测价值分析

目的 探讨游离睾酮指数(FTI)及血清Irisin对多囊卵巢综合征(PCOS)不孕患者体外受精-胚胎移植(IVF-ET)妊娠结局的预测价值。方法 选取自2019年6月至2021年6月文昌市人民医院收治的92例PCOS患者为研究对象,均采取IVF-ET治疗。根据PCOS患者的妊娠结果将其分为妊娠成功组(n=44)与妊娠失败组(n=48)。比较两组患者的年龄、体质量指数、不孕年限、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E₂)、睾酮(T)、游离睾酮(FT)、性激素结合球蛋白(SHBG)、游离睾酮指数(FTI)、抗苗勒管激素(AMH)值、血清Irisin、窦卵泡数(AFC)、促性腺激素(Gn)用量、获卵总数。采用多因素Logistic回归分析探讨PCOS患者IVF-ET的妊娠结局影响因素。基于各影响因素构建评分模型,绘制评分模型预测PCOS不孕患者IVF-ET后妊娠结局的受试者工作特征(ROC)曲线。结果 妊娠成功组患者的年龄、LH/FSH、FT、FTI、Irisin、Gn用量低于妊娠失败组,血清FSH、SHBG、获卵总数高于妊娠失败组,差异有统计学意义(P&...     

男性2型糖尿病患者血清瘦素水平与肥胖关系的探讨

目的观察男性2型糖尿病患者血清瘦素水平与肥胖之间的关系.方法用酶联免疫测定法测定男性糖尿病患者及对照组血清瘦素和真胰岛素水平.结果男性糖尿病组与非糖尿病组血清瘦素水平未见显著性差异(P＞0.05),而肥胖个体的血清瘦素水平高于非肥胖个体(t=3.5,P＜0.01),与体重指数呈正相关;男性肥胖组血清真胰岛素平均值高于非肥胖组(t=2.19,P＜0.05),与血清瘦素水平及体重指数均呈明显的正相关(P＜0.01和＜0.001).结论本研究结果提示:血清瘦素水平与糖尿病无直接相关性,而与人体肥胖程度密切相关.     

不同时期不孕症患者体内激素水平变化及临床意义

目的探讨不同时期不孕症患者体内激素水平变化及临床意义。方法将首都医科大学附属北京妇产医院自2015年1月至2016年12月收治的获得明确诊断的96例不孕症患者设为不孕症组,其中,卵泡期32例,排卵期29例,黄体期35例。同时,选取同期健康体检者100例为健康组,其中,卵泡期35例,排卵期34例,黄体期31例。检测所有受试者的卵泡雌激素、黄体生成素、雌二醇、垂体泌乳素、孕酮、睾酮水平,并对检测结果进行比较分析。结果不孕症组卵泡期患者卵泡雌激素、雌二醇、垂体泌乳素、孕酮、睾酮水平与健康组比较,差异有统计学意义(P<0.05);排卵期患者卵泡雌激素、黄体生成素、雌二醇、孕酮、睾酮水平与健康组比较,差异有统计学意义(P<0.05);黄体期患者黄体生成素、垂体泌乳素、孕酮水平与健康组比较,差异有统计学意义(P<0.05)。结论性激素水平的变化与不孕症的发生存在密切联系,展开血清性激素水平检测,对于不孕症的诊断具有重要意义,临床价值显著,值得关注并推广。     

瘦素应用于肥胖症研究

瘦素(leptin)是脂肪细胞合成和分泌的一种激素,是肥胖(ob)基因表达的产物,有抑制食欲、促进能量消耗的生理作用。多数研究表明,瘦素是脂肪分解和合成代谢的一个主要调节因子(负反馈),其水平的变化在临床上可作为早期高血脂症、脂肪肝等脂肪代谢率紊乱的灵敏指标。放射免疫分析(RIA)法对人血清(血浆)瘦素水平的精确测定和进一步研究表明,循环瘦素水平与体重指数(BMI)、年龄、性别、性激素及胰岛素内分泌等因素有关,特别是与BMI显著相关,提示多数肥胖个体存在瘦素抵抗。部分瘦素相对缺乏的肥胖者将有可能成为瘦素治疗的对象。瘦素的发现和应用使肥胖症及Ⅱ型糖尿病等相关疾病的研究进入了一个新阶段。     

男性糖尿病患者血清瘦素水平观察

目的　观察男性糖尿病患者血清瘦素水平与肥胖之间的关系。方法　用酶联免疫吸附法测定男性糖尿病患者及对照组血清瘦素和真胰岛素水平。结果　男性糖尿病组与非糖尿病组血清瘦素水平未见显著性差异 (P >0 0 5 ) ,而肥胖个体的血清瘦素水平高于非肥胖个体 (t=3 5 ,P <0 0 1) ,与体重指数呈正相关 ;男性肥胖组血清真胰岛素平均值高于非肥胖组 (t=2 19,P <0 0 5 ) ,与血清瘦素水平及体重指数均呈明显的正相关 (P <0 0 1和 <0 0 0 1)。结论　血清瘦素水平与糖尿病无直接相关关系 ,而与人体肥胖程度密切相关。     

Plasma levels of insulin and leptin in patients with morbid obesity and anorexia nervosa after weight loss or gain, respectively

The present study was conducted in order to analyze the relationship existing between leptin and insulin levels in massive weight loss and weight recovery. Thirteen patients with severe obesity, 14 patients with anorexia nervosa and 13 healthy control subjects were studied. The patients with severe obesity underwent a vertical banded gastroplasty followed by an 800 kcal/day diet for 12 weeks. They were evaluated prior to (body mass index [BMI] 51.2 +/- 8.8 Kg/m2) and after drastic weight loss (BMI 40.6 +/- 6.7 Kg/m2). Patients with anorexia nervosa were treated exclusively with nutritional therapy during 12 weeks, and they were evaluated at their lowest weight status (BMI 16.2 +/- 2.2 Kg/m2) and after weight recovery (BMI 17.9 +/- 2.3 Kg/m2). The BMI of the normal subjects was in the normal range of 20 to 27 Kg/m2 (average 22.8 +/- 2.6 Kg/m2). BMI, percentage of body fat, waist circumference, and serum levels of leptin, insulin, and C-peptide were determined in each patient and normal subject. In severely obese patients, serum leptin and insulin decreased significantly after drastic weight reduction (leptin: from 51.8 +/- 22.3 to 23.7 +/- 10.2 ng/ml; insulin: from 27.1 +/- 13.3 to 17.2 +/- 7.2 mU/ml). In patients with anorexia nervosa, the mean serum leptin levels were significantly higher after weight recovery (5.5 +/- 3.2 vs 7.6 +/- 6 ng/ml). Serum leptin in the severe obesity group correlated positively with BMI, percentage body fat and waist circumference before and after weight loss. In those patients suffering from anorexia nervosa, serum leptin correlated positively with the BMI, percentage of body fat, and waist circumference in the low weight state and after weight recovery. In addition, their serum insulin correlated with BMI and waist circumference after weight recovery. These data reveal that serum leptin concentration correlates significantly with the BMI and body fat content 1) in subjects with a range of weight and caloric intake, 2) in obese patients after drastic weight loss; 3) in anorexic patients after weight gain; and that hyper- or normoinsulinemia do not seem to have any influence on the leptin changes caused by weight loss or gain.     

中老年髋骨骨折患者血清脂联素和瘦素的水平研究

目的研究血清脂联素和瘦素水平与中老年人髋骨骨折的关系。方法选择2015年1月—12月在延安市人民医院骨科治疗的245例髋骨骨折患者。其中男性130例,女性115例;平均年龄64.26岁。另选择同时期在延安市人民医院体检中心体检的50岁以上健康人群510例作为对照,其中男性263例,女性247例;平均年龄62.20岁。应用放射免疫分析法测定245例髋骨骨折患者和510例健康对照的血清脂联素和瘦素水平,比较两组临床资料数据,包括年龄、BMI、收缩压、舒张压、吸烟、饮酒、锻炼、甘油三脂、低密度脂蛋白胆固醇等。采用Logistic回归分析计算不同脂联素和瘦素水平组发生髋骨骨折的风险。结果病例组年龄、BMI、收缩压、舒张压、甘油三脂、低密度脂蛋白胆固醇、脂联素和瘦素的水平显著高于对照组,差异有统计学意义(P0.05);病例组低密度脂蛋白胆固醇水平显著低于对照组,差异有统计学意义(P0.05)。病例组吸烟以及饮酒人群所占的比例显著高于对照组,差异有统计学意义(P0.05);而病例组进行体育锻炼的人群则显著低于对照组,差异有统计学意义(P0.05)。血清脂联素和瘦素水平越高,髋骨骨折的发生风险越大(P0.05),脂联素和瘦素最高水平组发生骨折的风险分别为最低水平组的1.40倍(OR,1.40;95%CI,1.09~1.77)和1.75倍(OR,1.75;95%CI,1.18~2.31)。结论血清脂联素和瘦素水平是髋骨骨折的独立危险因素。     

Determination of insulin, leptin and neuropeptide y by radioimmunoanalysis in patients with morbid obesity and anorexia nervosa after therapeutic intervention

The present study was conducted in order to analyze the relationship existing between leptin, insulin and neuropeptide Y (NPY) levels in massive weight loss and weight recovery. Twenty-three patients with severe obesity, 23 patients with anorexia nervosa and 28 healthy control subjects were studied. Patients with severe obesity underwent a vertical banded gastroplasty followed by an 800 kcal/day diet during 16 weeks, with evaluation taking place before (Body mass index, BMI, 52,1 8 Kg/m2) and after the drastic weight loss (BMI 39,2 6,2 Kg/m2). Patients with anorexia nervosa were treated with nutritional therapy exclusively during 16 weeks, and they were evaluated in the low weight situation (BMI 15,3 1,7 Kg/m2) and after weight recovery (BMI 18,9 2,8 Kg/m2). Normal subjects had a normal BMI from 20 to 27 (average 21,8 2 Kg/m2). BMI, percentage of body fat, and serum levels of leptin, insulin, and NPY, were determined in each patient and normal subjects. In severe obese patients serum leptin and insulin decreased significantly after drastic weight reduction (leptin: from 48,8 19,2 to 24,3 9,8 ng/ml; insulin: from 26,2 10,8 to 18 6 U/ml). In patients with anorexia nervosa serum leptin mean levels were significantly higher after weight recovery (3,7 1,9 vs 9,2 5,1 ng/ml). In subjects with morbid obesity NPY levels decreased after weight loss below those of control group (43,5 16,1 vs 57,3 12,8 pmol/l). On the other hand, patients with anorexia nervosa had NPY levels superior to those of control group. In subjects with anorexia, NPY levels decreased after weight recovery (69,1 16,7 a 59,1 20,3 pmol/l). In the whole population, Leptin and NPY plasma levels were correlated with body fat percentage. Leptin was positively correlated with BMI and body fat percentage in obese and anorectic subjects after weight loss or recovery, respectively. NPY was inversely correlated with body fat percentage in controls and obese subjects before treatment. These data reveal that the concentration of serum leptin and NPY correlates significantly with the total adiposity in subjects with a wide weight range and caloric intake. Leptin plasma levels are proportional to fat stores in patients with severe obesity and anorexia nervosa after drastic weight loss or recovery, respectively. NPY serum levels are negatively correlated with de total body fat in normal weight subjects and obese patients in their initial weight.     

慢性肾功能衰竭不同分期患者血清瘦素水平变化及临床意义

目的研究慢性肾功能衰竭（chronic renal failure,CRF）不同分期患者血清瘦素（Leptin）水平,以及不同透析方法对其水平的影响,同时还观察瘦素水平与临床指标（肾功能指标：Scr、BUN;营养指标：TP、Alb、PAB、TRF、CH、TG、HDL-C、LDL-C、RBC、Hb、HCT）之间的关系。方法以放射免疫法（RIA）检测CRF患者血清瘦素的水平;利用酶联免疫吸附法（ELISA）测定血清前白蛋白（PAB）和转铁蛋白（TRF）;利用全自动生化分析仪检测血肌酐（Scr）、血尿素氮（BUN）、血红蛋白（Hb）、胆固醇（CH）等其他有关指标;采用SPSS11.5软件进行所有数据的统计分析。结果 CRF患者血总蛋白（TP）、白蛋白（Alb）、前白蛋白（PAB）、红细胞压积（HCT）、Hb、体重指数（BMI）、转铁蛋白（TRF）均在较低水平。血清瘦素水平为对照组（7.35±0.94μg）、肾功能代偿期及失代偿期组（12.36±6.03μg）、肾功能衰竭期及尿毒症期组（25.27±3.27μg）、维持性血液透析组（7.69±6.61μg）、维持性腹膜透析组（20.72±14.93μg）,CRF4个亚组患者血清瘦素水平均高于正常对照组。结论不同阶段的CRF患者血TP、Alb、Hb、PAB、HCT、BMI均在较低水平,提示CRF患者普遍存在营养不良。不同阶段的CRF患者普遍存在高瘦素血症,且随肾功能损害的进展,血清瘦素成上升趋势。CRF患者血清瘦素升高与Scr及BUN成正相关,提示肾脏是清除瘦素的主要器官。血液透析患者血清瘦素明显降低,提示血液透析能有效降低血清瘦素水平。腹膜透析患者血清瘦素水平升高,提示腹膜透析不能有效降低血清瘦素水平。     

民航非酒精性脂肪肝飞行员血清瘦素、血糖和血脂变化的研究

目的分析2009年4月至2010年7月在民航广州医院航空体检中心体检的民航60例现役非酒精性脂肪肝（nonalcoholic fatty liver disease, NAFLD）飞行员血清瘦素、血糖、血脂的变化,探讨飞行员患NAFLD的危险因素及其预防措施。方法60例NAFLD飞行员作为试验组,体检结论正常的60例飞行员作为对照组。询问病史,空腹测量身高、体重、腰围、臀围及血压;检测血脂、空腹血糖（fasting plasma glucose,FPG）和血清瘦素水平,并进行组间比较。结果NAFLD组体重指数（bodymass index,BMI）、腰臀比、收缩压、舒张压、甘油三酯（triglyceride,TG）和血清瘦素水平较对照组显著上升（t=4．62-12．20,P〈0．01）;FPG较对照组上升（t=2．63,P〈0．05）;高密度脂蛋白胆固醇（highdensitylipid—cholesterol,HDL-C）明显下降（t=3．65,P〈0．01）。瘦素水平与TG、FPG呈正相关（r=0．72、0．82,P〈0．05）,与HDL-C呈负相关（r=-0．62,P〈0．05）。结论飞行员患NAFLD与其饮食结构及活动减少造成肥胖有关,并与瘦素水平升高密切关联。应加强对患NAFLD飞行员的预防和治疗工作,为飞行员的健康和飞行安全提供保障。     

Obesity, energy regulation and thyroid function: is borderline elevated TSH-level the cause or secondary phenomenon of obesity

Several population-based studies have shown a significant association between TSH-level and BMI (body mass index). About 30% of the rest energy expenditure are regulated by thyroid hormones, which generated the hypothesis that thyroid hormone substitution with TSH-titration into the lower reference levels may prevent body weight gain. The opposite effect of thyroid hormones is appetite stimulation, which may be responsible for body weight gain in case of substitutive medication. The association between TSH and BMI has become a complex topic in the light of the endocrine activity of adipocytes. Adipocytes are not a silent fat mass, but increase the hormone level of leptin, which influences neurones in the hypothalamus, the thyreotropic axis and TSH secretion. BMI is positively correlated with serum leptin. Elevated leptin levels, endogenous in individuals with high BMI or exogenous after leptin injection for treatment of hypothalamic amenorrhoea, shift TSH in the upper reference level. Borderline elevated TSH levels are reversible in case of body weight reduction in obese persons. It remains unclear whether high TSH levels or high leptin level are responsible for obesity or represent secondary phenomenon. Recommendation for daily practice: Borderline elevated TSH-levels in obese patients will decrease in case of body weight reduction without hormone medication. After definitive treatment of hyperthyroidism patient's history for use of carbohydrates (increased during hyperthyroidism) should be noticed and substitution with thyroid hormones aims at TSH in the lower reference level. As body weight gain is observed in all TSH groups, a special concept for prevention and therapy of obesity (diet, daily exercise, behaviour training) should be initiated early and additionally to medication.     

肥胖者外周脂肪组织中leptin受体水平的研究

目的　研究肥胖者外周脂肪组织瘦素 (leptin)受体表达及探讨肥胖发生发展的机制。方法　用放射配基受体结合方法 ,检测 71例受检者 (其中肥胖 32例 ,超重 1 9例 ,正常对照 2 0例 )外周脂肪组织leptin受体密度。结果　随着体重指数 (BMI)的增加 ,肥胖组和超重组leptin受体密度与对照组比较差异有显著性 (P <0 0 1 ) ,肥胖组与超重组比较差异亦有显著性 (P <0 0 1 ) ;而受体与leptin的结合能力 (Kd 值 )差异无显著性 (P >0 0 5)。 3组间Kd 值差异无显著性 ,表明leptin受体与配基的结合能力与BMI无关。从散点分布图看 ,BMI越大其leptin受体密度越小 ,BMI与最大结合量相关 (r=- 0 76 ,P <0 0 1 )。结论　肥胖者外周脂肪组织中leptin受体的表达与BMI密切相关 ,而肥胖者血液中leptin水平升高 ,表明体内存在leptin受体水平下调致leptin耐受 ,继而形成肥胖。