Normal reproductive function in leptin-deficient patients with lipoatropic diabetes.

Normal reproductive function in leptin-deficient patients with lipoatropic diabetes.
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瘦素缺乏的脂肪代谢性糖尿病患者的正常生殖功能。

DOI:
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发表时间:
2000
影响因子:
5.8
通讯作者:
Charles Thivolet
Charles Thivolet
中科院分区:
医学2区
文献类型:
--
作者:
Fabrizio Andreelli;H. Hanaire;Martine Laville;J. Tauber;Jean;Charles Thivolet

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为了进一步研究瘦素和女性生殖轴之间的关系,我们对两名青春期前发生的脂肪萎缩性糖尿病患者进行了激素研究。尽管sc和内脏脂肪组织完全萎缩,这两个患者在11-12岁之间出现月经初潮,随后月经周期规律。一名患者曾怀孕三次,生下的孩子没有患上这种疾病。在我们的两名患者中,重复分析显示瘦素水平低于1 ng/mL(20名接受胰岛素治疗的糖尿病女性的正常范围,体重指数为14-39 kg/m2时为2-23 ng/mL;个人数据)。我们在月经周期的前5天内测量外周雌二醇、孕酮、FSH、LH、游离睾酮和雄烯二酮的水平,并在静脉注射100 μ g GnRH后检测垂体的反应性。并对晨起前体温变化进行分析。我们发现:1)两名患者的所有激素测量水平均在正常范围内; 2)低水平的瘦素不会损害一名患者生殖功能的发育,并且与两名患者的正常性腺功能相关。我们的结论是,尽管血清瘦素水平长期低下,但青春期和生育能力仍可能发生。这表明,瘦素不是维持人类正常生殖功能的基础。
To further examine the relationships between leptin and female reproductive axis, we conducted hormonal studies in two patients with lipoatropic diabetes that occurred before puberty. Despite complete atrophy of sc and visceral adipose tissue, menarche occurred in these two patients between 11-12 yr of age, followed by regular menstrual cycles. One patient had been pregnant three times, giving birth to children who did not develop the disease. In our two patients, repeated analysis revealed leptin levels below 1 ng/mL (normal range for 20 insulin-treated diabetic women, 2-23 ng/mL for body mass index of 14-39 kg/m2; personal data). We measured peripheral levels of estradiol, progesterone, FSH, LH, free testosterone, and androstenedione within the first 5 days of the menstrual cycle, and we tested the reactivity of pituitary after iv injection of 100 microg GnRH. The variation in body temperature in the morning before arising was also analyzed. We showed that 1) all measured levels of hormones were in the normal range for both patients; and 2) low levels of leptin did not impair the development of reproductive function in one patient and was associated with normal gonadal function in both patients. We conclude that puberty and fertility can occur despite chronic low serum levels of leptin. This suggests that leptin is not fundamental to the maintenance of normal reproductive function in humans.
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发表时间: 1995-07-28
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