目的:比较成人生长激素缺乏症(Adult growth hormone deficiency,AGHD)患者与健康成人血清妊娠相关蛋白A(Preg-nancy-associated plasma protein A,PAPP-A)水平及其与糖脂代谢、血压、游离脂肪酸、C反应蛋白等的关系。方法:采用酶联免...目的:比较成人生长激素缺乏症(Adult growth hormone deficiency,AGHD)患者与健康成人血清妊娠相关蛋白A(Preg-nancy-associated plasma protein A,PAPP-A)水平及其与糖脂代谢、血压、游离脂肪酸、C反应蛋白等的关系。方法:采用酶联免疫吸附法检测20例AGHD患者和20例健康成人的血清妊娠相关蛋白A水平,同时检测空腹血糖、血脂谱、空腹胰岛素、游离脂肪酸、C反应蛋白等,计算体重指数,并以稳态模型评估胰岛素抵抗指数(Homeostasis model assessment index for insulin resis-tance,HOMA-IR)和胰岛素分泌指数(Homeostasis model assessment ofβ-cell function,HOMA-β)。结果:AGHD患者血清妊娠相关蛋白A高于对照组[7.57(6.59～8.96)与6.20(5.78～6.96)比较,P<0.05]。AGHD患者血清PAPP-A与年龄、体重指数、腰围、腰臀比、收缩压、餐后2 h血糖、空腹胰岛素、HOMA-IR正相关r(值依次为0.451、0.878、0.813、0.605、0.489、0.549、0.503、0.487;均P<0.05);在调整腰围、腰臀比、餐后2 h血糖、甘油三酯后,AGHD患者血清妊娠相关蛋白A与体重指数、空腹胰岛素正相关r(值依次为0.728、0.433;均P<0.05)。多元回归分析提示,体重指数、餐后2 h血糖、空腹胰岛素、HOMA-IR是AGHD患者血清PAPP-A的独立相关因素。结论:AGHD患者血清PAPP-A升高,并与体重指数、餐后2 h血糖、空腹胰岛素、HOMA-IR相关。提示在AGHD患者中,血清PAPP-A可能与动脉粥样硬化及糖代谢有联系。展开更多
Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-ye...Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.展开更多
文摘目的:比较成人生长激素缺乏症(Adult growth hormone deficiency,AGHD)患者与健康成人血清妊娠相关蛋白A(Preg-nancy-associated plasma protein A,PAPP-A)水平及其与糖脂代谢、血压、游离脂肪酸、C反应蛋白等的关系。方法:采用酶联免疫吸附法检测20例AGHD患者和20例健康成人的血清妊娠相关蛋白A水平,同时检测空腹血糖、血脂谱、空腹胰岛素、游离脂肪酸、C反应蛋白等,计算体重指数,并以稳态模型评估胰岛素抵抗指数(Homeostasis model assessment index for insulin resis-tance,HOMA-IR)和胰岛素分泌指数(Homeostasis model assessment ofβ-cell function,HOMA-β)。结果:AGHD患者血清妊娠相关蛋白A高于对照组[7.57(6.59～8.96)与6.20(5.78～6.96)比较,P<0.05]。AGHD患者血清PAPP-A与年龄、体重指数、腰围、腰臀比、收缩压、餐后2 h血糖、空腹胰岛素、HOMA-IR正相关r(值依次为0.451、0.878、0.813、0.605、0.489、0.549、0.503、0.487;均P<0.05);在调整腰围、腰臀比、餐后2 h血糖、甘油三酯后,AGHD患者血清妊娠相关蛋白A与体重指数、空腹胰岛素正相关r(值依次为0.728、0.433;均P<0.05)。多元回归分析提示,体重指数、餐后2 h血糖、空腹胰岛素、HOMA-IR是AGHD患者血清PAPP-A的独立相关因素。结论:AGHD患者血清PAPP-A升高,并与体重指数、餐后2 h血糖、空腹胰岛素、HOMA-IR相关。提示在AGHD患者中,血清PAPP-A可能与动脉粥样硬化及糖代谢有联系。
文摘Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.
