[1]李晨曦,章秋,胡红琳,等.GnRH脉冲治疗对男性HH患者体脂分布 和胰岛素抵抗的影响[J].国际内分泌代谢杂志,2016,36(04):237-240.[doi:10.3760/cma.j.issn.1673-4157.2016.04.07]
　Li Chenxi,Zhang Qiu,Hu Honglin,et al.Effects of GnRH pump treatment on fat distribution and insulin resistance in men with HH[J].International Journal of Endocrinology and Metabolism,2016,36(04):237-240.[doi:10.3760/cma.j.issn.1673-4157.2016.04.07]
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GnRH脉冲治疗对男性HH患者体脂分布 和胰岛素抵抗的影响()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
36
期数:
2016年04期
页码:
237-240
栏目:
论著
出版日期:
2016-07-20

文章信息/Info

Title:
Effects of GnRH pump treatment on fat distribution and insulin resistance in men with HH
作者:
李晨曦; 章秋; 胡红琳; 代芳; 邓大同; 王长江
230032 合肥,安徽医科大学第一附属医院内分泌科
Author(s):
Li Chenxi;  Zhang Qiu;  Hu Honglin;  Dai Fang;  Deng Datong;  Wang Changjiang
Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230032, China
关键词:
性腺功能减退症;  促性腺激素释放激素;  输注泵;  体脂分布;  胰岛素抵抗
Keywords:
Hypogonadism;  Gonadotropin-releasing hormone;  Infusion pumps;  Fat distribution;  Insulin resistance
DOI:
10.3760/cma.j.issn.1673-4157.2016.04.07
摘要:
目的 研究促性腺激素释放激素(GnRH)脉冲治疗对男性低促性腺激素性性腺功能减退症(HH)患者体脂分布和胰岛素抵抗的影响。方法 选取2013年2月至2015年1月在安徽医科大学第一附属医院就诊的20例男性HH患者为研究对象,测定GnRH脉冲治疗前、后患者性激素、血脂、空腹血糖、空腹胰岛素(FINS)、性激素结合球蛋白(SHBG)等生化指标,计算稳态模型评估-胰岛素抵抗指数(HOMA-IR),并运用双能X线骨密度仪检测全身、躯干及大腿脂肪量和瘦体重,计算所占各自总质量的百分比。 结果 经GnRH脉冲治疗6个月后,男性HH患者骨骺闭合人数、卵泡刺激素、黄体生成素、总睾酮、游离睾酮、总瘦体重百分比和躯干瘦体重百分比水平较治疗前增加,FINS、HOMA-IR、总脂肪量百分比和躯干脂肪量百分比水平较治疗前降低(t=-4.169～3.630,P均<0.05)。Pearson相关性分析提示,HOMA-IR与总睾酮(r=-0.676,P=0.032)、游离睾酮(r=-0.731,P=0.016)、躯干瘦体重百分比(r=-0.750,P=0.012)呈负相关,与FINS(r=0.937,P=0.000)、躯干脂肪量百分比(r=0.750,P=0.012)呈正相关。 结论 GnRH脉冲治疗可减轻男性HH患者的胰岛素抵抗,改变其体脂分布; 睾酮水平和躯干瘦体重百分比的升高、FINS水平和躯干脂肪量百分比的降低可能与胰岛素抵抗的改善有关。
Abstract:
Objective To investigate the effects of gonadotropin-releasing hormone(GnRH)pump treatment on fat distribution and insulin resistance in men with hypogonadotropic hypogonadism(HH). Methods A total of 20 male HH patients were enrolled from February 2013 to January 2015 in The First Affiliated Hospital of Anhui Medical University. Serum sex hormones, lipid profile, fasting blood glucose(FBG), fasting insulin(FINS)and sex hormone binding globulin(SHBG)were measured and compared before and after the treatment. Homeostasis model assessment of insulin resistance(HOMA-IR)was calculated. Dual energy X-ray absorptiometry(DEXA)was used to calculate the percentage of fat mass and lean mass in the whole body, trunk and thigh. Results After 6 months of GnRH pump treatment, the number of closed bone epiphysis, follicle-stimulating hormone, luteinizing hormone, total testosterone, free testosterone, the percentage of body lean mass and trunk lean mass were increased, while FINS, HOMA-IR, the percentage of body fat mass and trunk fat mass were decreased in male patients with HH(t=-4.169-3.630,all P<0.05). Pearson correlation analysis revealed that HOMA-IR was negatively correlated with total testosterone(r=-0.676, P=0.032), free testosterone(r=-0.731, P=0.016)and the percentage of trunk lean mass(r=-0.750, P=0.012), and was positively correlated with FINS(r=0.937,P=0.000)and the percentage of trunk fat mass(r=0.750, P=0.012). Conclusions GnRH pump treatment can reduce insulin resistance and alter fat distribution in male patients with HH. The increase of testosterone and percentage of trunk lean mass, and the decrease of FINS and percentage of trunk fat mass may lead to the improvement of insulin resistance.

参考文献/References:

[1] 赵芳雅, 陈海冰. 男性低促性腺激素性性腺功能减退症的诊治[J]. 中华内分泌代谢杂志,2013,29(11):998-1001.DOI:10.3760/cma.j.issn.1000-6699.2013.11.021.
[2] 张世林, 王涛, 刘卓, 等. 男性特发性低促性腺激素型性腺功能减退症的诊治分析[J]. 中华泌尿外科杂志,2012,33(3):228-231.DOI:10.3760/cma.j.issn.1000-6702.2012.03.021.
[3] Sonmez A, Haymana C, Bolu E,et al. Metabolic syndrome and the effect of testosterone treatment in young men with congenital hypogonadotropic hypogonadism[J].Eur J Endocrinol,2011,164(5):759-764. DOI:10.1530/EJE-10-0951.
[4] Saad F, Gooren L. The role of testosterone in the metabolic syndrome: a review[J].J Steroid Biochem Mol Biol,2009,114(1-2):40-43.
[5] 孙首悦, 王卫庆, 蒋怡然, 等. 微量泵脉冲输注戈那瑞林治疗特发性低促性腺激素性性腺功能减退症[J]. 中华内分泌代谢杂志,2011,27(8):654-658.DOI:10.3760/cma.j.issn.1000-6699.2011.08.011.
[6] 黄炳昆, 茅江峰, 徐洪丽, 等. GnRH脉冲输注与HCG/HMG联合肌注对男性IHH患者生精治疗效果比较[J].中华医学杂志,2015,95(20):1568-1571. DOI:10.3760/cma.j.issn.0376-2491.2015.20.005.
[7] Rao PM, Kelly DM, Jones TH.Testosterone and insulin resistance in the metabolic syndrome and T2DM in men[J].Nat Rev Endocrinol,2013,9(8):479-493.DOI: 10.1038/nrendo.2013.122.
[8] Naharci MI, Pinar M, Bolu E,et al. Effect of testosterone on insulin sensitivity in men with idiopathic hypogonadotropic hypogonadism[J].Endocr Pract,2007,13(6):629-635.
[9] Yialamas MA, Dwyer AA, Hanley E,et al. Acute sex steroid withdrawal reduces insulin sensitivity in healthy men with idiopathic hypogonadotropic hypogonadism[J].J Clin Endocrinol Metab,2007,92(11):4254-4259.
[10] 杨晓洁, 姚晓红, 严款, 等. 成人体脂分布与胰岛素抵抗、胰岛β细胞功能及代谢紊乱的关系[J]. 中华医学杂志, 2013,93(36):2867-2870. DOI:10.3760/cma.j.issn.0376-2491.2013.36.006.
[11] Oka R, Miura K, Sakurai M,et al. Impacts of visceral adipose tissue and subcutaneous adipose tissue on metabolic risk factorsin middle-aged Japanese[J]. Obesity(Silver Spring),2010,18(1):153-160. DOI: 10.1038/oby.2009.180.
[12] Morelli A, Sarchielli E, Comeglio P,et al. Metabolic syndrome induces inflammation and impairs gonadotropin-releasing hormone neurons in the preoptic area of the hypothalamus in rabbits[J].Mol Cell Endocrinol,2014,382(1):107-119. DOI: 10.1016/j.mce.2013.09.017.
[13] Corona G, Monami M, Rastrelli G,et al. Testosterone and metabolic syndrome: a meta-analysis study[J].J Sex Med,2011,8(1):272-283. DOI:10.1111/j.1743-6109.2010.01991.x.
[14] Aydogdu A, Bolu E, Sonmez A,et al. Effects of three different medications on metabolic parameters and testicular volume in patients with hypogonadotropic hypogonadism: 3-year experience[J].Clin Endocrinol(Oxf),2013,79(2):243-251.DOI: 10.1111/cen.12135.
[15] 关迪. 男性雄激素缺乏症与代谢综合征[J]. 国际生殖健康/计划生育杂志,2011,30(1):21-24.DOI:10.3969/j.issn.1674-1889.2011.01.006.

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备注/Memo

备注/Memo:
通信作者:章秋,Email:aynfmk@163.com
更新日期/Last Update: 2016-09-20