论文部分内容阅读
目的探讨真性性早熟(CPP)女童肾上腺机能初现及是否具有肾上腺机能早现、高肾上腺雄激素血症、高胰岛素血症和胰岛素抵抗现象。方法以2006年8月1日至2007年8月1日舟山市妇幼保健院中符合纳入标准的CPP女童26例为研究对象,年龄(7.9±1.1)岁,以27例同期健康女童为对照组,年龄(7.8±1.3)岁。在隔夜空腹12h后,进行身体检查,并抽血检测空腹血糖、胰岛素、硫化脱氢表雄酮、皮质醇和雄烯二酮。胰岛素敏感性用胰岛素抵抗指数(HOMA-IR)评价。结果两组中均未发现肾上腺机能早现的临床表现。两组间体重指数、空腹血糖、皮质醇、硫化脱氢表雄酮、雄烯二酮和胰岛素抵抗指数差异无统计学意义。性早熟女童体重指数与胰岛素抵抗指数呈正相关(r=0.43,P<0.05)。性早熟合并超重或肥胖的女童血胰岛素水平、硫化脱氢表雄酮水平及胰岛素抵抗指数较正常对照组明显升高。结论真性性早熟女童未发现肾上腺机能早现、高肾上腺雄激素血症、高胰岛素血症和胰岛素抵抗现象。性早熟合并超重或肥胖的女童有胰岛素抵抗现象。
Objective To investigate whether adrenal function is present in adolescent with precocious puberty (CPP) and whether it has premature adrenal function, hyper-adrenal androgenic status, hyperinsulinemia and insulin resistance. Methods From August 1, 2006 to August 1, 2007, 26 eligible CPP girls in Zhoushan Maternal and Child Health Care Hospital were enrolled in this study. The age (7.9 ± 1.1) years old and 27 healthy girls , Age (7.8 ± 1.3) years old. After 12 hours of fasting overnight, physical examinations were performed and blood was drawn for fasting plasma glucose, insulin, sulfydryl hydroperoxide, cortisol and androstenedione. Insulin sensitivity was assessed using insulin resistance index (HOMA-IR). Results No clinical manifestations of adrenal function were found in both groups. Body mass index, fasting blood glucose, cortisol, sulfated dehydroepiandrosterone, androstenedione and insulin resistance index showed no significant difference between the two groups. Premature girls had a positive correlation between body mass index and insulin resistance index (r = 0.43, P <0.05). Compared with the normal control group, the levels of blood insulin, the levels of sulfated dehydroepiandrosterone and insulin resistance in girls with precocious puberty and overweight or obesity were significantly higher than those in normal controls. Conclusion There are no premature adrenal glands, hyper-adrenal androgenic hyperinsulinemia, hyperinsulinemia and insulin resistance found in girls with authentic precocity. Premature girls with overweight or obesity have insulin resistance.