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目的 研究特发性中枢性性早熟 (ICPP)女孩青春各期血清瘦素 (leptin)和胰岛素样生长因子Ⅰ (IGF Ⅰ )的变化规律。方法 测定 39例 (4 9例次 )处于青春各期的ICPP女孩以及其中 9例接受促性腺激素释放激素类似物(GnRH a)治疗开始和 6个月末的血leptin和IGF Ⅰ水平 ,并行阴道涂片检查计算阴道上皮成熟指数 (MI) ,同时以 15例正常青春前期女孩作为对照。结果 ICPP女孩青春早、中和晚期血leptin、IGF Ⅰ水平均高于对照组 (P <0 0 5或P <0 0 1)。青春中期血leptin与早期无差异 ,晚期高于早期 (P <0 0 5 )。青春中期血IGF Ⅰ较早期有增加趋势 ,青春晚期显著高于早、中期 (均P <0 0 1)。青春期血leptin与体重指数 (BMI)正相关 (r =0 5 0 ,P <0 0 1) ,而与青春分期、MI及IGF Ⅰ不相关。IGF Ⅰ与青春分期、BMI和MI正相关。血leptin和IGF Ⅰ不相关。GnRH a治疗 6个月前后 ,血leptin和IGF Ⅰ无显著改变。结论 ICPP女孩血leptin和IGF Ⅰ水平均在青春早期显著增加 ,并与青春发育进程平行。 6个月的GnRH a治疗对血leptin和IGF Ⅰ水平无明显影响。血leptin水平和BMI正相关 ,而与雌激素水平、IGF Ⅰ水平没有直接的联系。
Objective To study the changes of serum leptin and insulin - like growth factor Ⅰ (IGF Ⅰ) in adolescent girls with idiopathic central precocious puberty (ICPP). Methods 39 cases (49 cases) of ICPP girls in adolescence and 9 cases of leptin and IGF Ⅰ levels of blood were collected at the beginning and 6 months of treatment with gonadotropin-releasing hormone analogue (GnRH a) Vaginal epithelial maturation index (MI) was calculated and 15 normal pre-teen girls were used as controls. Results The levels of leptin, IGF Ⅰ in early, middle and late stage blood of ICPP girls were higher than those of the control group (P <0.05 or P <0.01). There was no difference between early stage leptin and early stage blood leptin in early adulthood (P <0 05). IGF Ⅰ in mid-adolescent blood had an increasing tendency compared with the early stage, and was significantly higher in late adolescence than in early and mid-term (all P <0.01). Adolescent blood leptin was positively correlated with body mass index (BMI) (r = 0.05, P <0.01), but not with staging, MI and IGF Ⅰ. IGF Ⅰ was positively correlated with staging, BMI and MI. Blood leptin and IGF Ⅰ are not related. After 6 months of GnRH treatment, there was no significant change in blood leptin and IGF Ⅰ. Conclusion The levels of blood leptin and IGF Ⅰ in ICPP girls increased significantly in early youth and paralleled with the development of youth. Six-month GnRH treatment had no significant effect on leptin and IGF I levels. Blood leptin levels and BMI are positively correlated, but not with estrogen levels, IGF Ⅰ levels are not directly linked.