月后,血清 瘦素水平由治疗前的(20.5±7.4)μg/L下降为(9.6±3.6)μg/L,同时体脂含量及体脂百 分率也明显下降。可以看出:青春期延迟的男孩有一个较高水平的瘦素,经睾酮治疗后, 随着体脂的下降血清瘦素水平也明显减低〔23〕。 Jockenhovel等对睾丸功能减退者,用睾酮替代治疗也发现:在治疗前患者血清瘦素水平 较正常人高三倍,尽管患者和正常人有相近的BMI。经治疗后患者血清瘦素水平也明显下 降。认为,睾丸功能减退者可能存在有瘦素抵抗状态,这种状态可以被雄激素诱导减低血 清瘦素水平而纠正,这样可以恢复患者对瘦素作用的反应〔18〕。
综上所述,瘦素对青春期的发动以及青春期发育都有一定的作用。青春期的发动是由于下 丘脑GnRH的脉冲释放峰度和频率增加所致。近年来研究发现:许多调控因子,包括类固醇、 神经介质、肽类激素等都能影响GnRH的分泌,这些因子可以兴奋和抑制GnRH的释放,有的更 具有兴奋/抑制的双向效应,即在特定情况下对GnRH分泌的调控转换成相反的作用〔24 〕。因此,青春期发动的确切机制以及瘦素的作用原理还有待进一步的研究。
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