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目的:探讨肥胖男性青少年性发育特点并对性激素水平进行分析。方法:选择自2010年1月至2012年6月期间到我院泌尿外科因小睾丸、小阴茎就诊的肥胖男性青少年156例为观察组,对照组选择社区健康青少年男性50例,测算两组对象的体重指数(BMI)、阴茎自然长度、睾丸容积并询问有无遗精及首次遗精年龄,采用放射免疫分析法测定血清黄体生成素(LH)、卵泡刺激激素(FSH)、催乳素(PRL)、总睾酮(TT)、游离睾酮(FT)、孕激素(P)和雌二醇(E2)水平,并计算TT/E2、睾酮分泌指数(TSI)。结果:①观察组BMI[(27.1±2.2)kg/m2]显著高于对照组[(20.4±1.6)kg/m2](P<0.05),阴茎自然长度[(5.6±1.7)cm]及睾丸平均容积[(7.6±2.3)cm3]显著小于对照组(P<0.05);两组青少年首次发生遗精年龄未现显著性差异(P>0.05),但观察组遗精发生率较对照组有极显著性下降(χ2=17.335,P<0.05)。②观察组血清LH、FSH、PRL、TT、FT、E2、P分别为(7.82±2.14)mIU/ml、(7.71±1.83)mIU/ml、(8.91±3.52)ng/ml、(0.73±0.20)ng/ml、(5.09±2.60)pg/ml、(48.57±8.34)pg/ml、(1.25±0.58)ng/ml,对照组分别为(5.39±1.76)mIU/ml、(6.82±2.01)mIU/ml、(8.26±2.97)ng/ml、(1.47±0.41)ng/ml、(11.28±4.72)pg/ml、(8.61±4.08)pg/ml、(0.64±0.19)ng/ml,其中观察组LH、E2、P显著高于对照组(P<0.05,P<0.01,P<0.05),TT、FT显著低于对照组(P均<0.01)。观察组TT/E2值(0.015±0.004)较对照组(0.173±0.037)显著降低(P<0.01);观察组TSI为(0.098±0.026),显著低于对照组(0.272±0.084,P<0.01)。③相关分析表明,BMI与PRL、E2呈显著正相关,与TT、FT、TT/E2及TSI呈显著负相关(P<0.05);阴茎自然长度与TT、FT、TT/E2及TSI呈显著正相关,与E2呈显著负相关(P<0.05);睾丸平均容积与LH、PRL、E2呈负相关,与TT、FT、TT/E2、TSI呈正相关(P<0.05)。结论:肥胖男性青少年存在性发育不良及性激素水平改变,肥胖及脂肪积聚导致E2增高、TT及FT下降、TT/E2、TSI下降尤为明显并与性发育存在显著相关性,提示男性青少年体内的脂肪含量对其生殖系统发育具有重要影响。
Objective: To investigate the sexual development characteristics of obese male adolescents and to analyze the sex hormones. Methods: From January 2010 to June 2012, 156 obese male adolescents treated by small testes and small penis in urology department of our hospital were selected as the observation group, 50 healthy male adolescents in the control group were selected as control group, The body mass index (BMI), penis length, testicular volume and asked whether there is no spermatorrhea and the age of first spermatorrhea were measured by radioimmunoassay. Serum LH, FSH, PRL, Total testosterone (TT), free testosterone (FT), progesterone (P) and estradiol (E2) were calculated. TT / E2 and TSI were calculated. Results: ① The BMI in the observation group was significantly (27.1 ± 2.2) kg / m 2 higher than that in the control group [(20.4 ± 1.6) kg / m 2 [P <0.05] The average volume [(7.6 ± 2.3) cm3] was significantly less than that of the control group (P <0.05). There was no significant difference in age at first spermatorrhea between the two groups (P> 0.05), but the incidence of spermatorrhea in the observation group was significantly higher than that in the control group Sex decreased (χ2 = 17.335, P <0.05). ② The serum levels of LH, FSH, PRL, TT, FT, E2 and P in the observation group were (7.82 ± 2.14) mIU / ml and (7.71 ± 1.83) mIU / ml and (8.91 ± 3.52) ng / ml, (5.09 ± 2.60) pg / ml, (48.57 ± 8.34) pg / ml and (1.25 ± 0.58) ng / ml respectively in the control group were (5.39 ± 1.76) mIU / ml and (6.82 ± 2.01) (8.26 ± 2.97) ng / ml, (1.47 ± 0.41) ng / ml, (11.28 ± 4.72) pg / ml, (8.61 ± 4.08) pg / ml and The levels of LH, E2 and P in the observation group were significantly higher than those in the control group (P <0.05, P <0.01, P <0.05), and the levels of TT and FT in the observation group were significantly lower than those in the control group (P <0.01). The TT / E2 value of the observation group (0.015 ± 0.004) was significantly lower than that of the control group (0.173 ± 0.037) (P <0.01); the TSI of the observation group was (0.098 ± 0.026), significantly lower than that of the control group ). ③ Correlation analysis showed that there was a significant positive correlation between BMI and PRL and E2, and negative correlation with TT, FT, TT / E2 and TSI (P <0.05). The penile natural length was significantly correlated with TT, FT, TT / E2 and TSI (P <0.05). The mean volume of testis was negatively correlated with LH, PRL and E2, and positively correlated with TT, FT, TT / E2 and TSI (P <0.05). CONCLUSIONS: Obese male adolescents have impaired sexual development and sex hormone levels. Obese and fat accumulation lead to increased E2, decreased TT and FT, especially decreased TT / E2 and TSI, which are significantly correlated with sexual development, suggesting that male adolescent fat The content of its reproductive system development has an important impact.