JCEM：青少年胰岛素增敏治疗可防范成年雄激素过多的表型

EE-CA和PioFluMet化疗中会和化疗后CRP、CIMT、肌肉组织胆固醇和MSI变化

施打雌-HT是愈来愈恋人睾酮相当多的规格化疗，即使当这些孩子们不能胎儿的高风险。为了比较施打避孕药与激素增敏化疗介入非肥胖症孩童，在化疗中会和化疗后对睾酮相当多的因素，来自巴萨罗那大学Sant Joan de Deu医院内分泌科的Lourdes Ibanez教授及其团队进行了一项研究，该研究断定孩童激素增敏化疗介入这样一来防范成年大部分睾酮相当多表改型。该研究结果在线刊出在2012年4年初1日的新泽西州《临床内分泌代谢时尚杂志》（The journal of clinical endocrinology & metabolism）上。该研究是一项随机非盲试验，受试者是颇高激素酸中毒和睾酮相当多的非肥胖症愈来愈恋人，且不能胎儿的高风险（34事例；同期16岁；肥胖症净资产：23kg/m2）。研究比较炔雌醇醋酸环丙雌激素（EE-CA）与小剂量酮类列酮（7.5mg/d）、钠他米特（62.5mg/d）和二甲双亚胺（850mg/d）联合（PioFluMet）化疗18个年初的。化疗后随访6年初。测量睾酮相当多（平卧症、痤疮评分和肝脏睾酮），刺激后激素，循环C重排蛋白，背动脉粘液中会层厚度，四肢组成（转化测量法），臀部胆固醇分区（磁共振成像）和性腺。该研究结果表明，EE-CA和PioFluMet或多或少缓解睾酮相当多，但有差异，以致因素其他结果。化疗后6个年初，PioFluMet化疗的孩子们比EE-CA化疗的孩子们有愈来愈极低的刺激后激素，愈来愈极低的C重排蛋白极低水平和愈来愈微的粘液中会层，并且他们的肌肉组织胆固醇较愈来愈少，具有愈来愈颇高的瘦肥胖症，以及愈来愈这样一来有规律的性腺。该研究断定，在非肥胖症的睾酮相当多的孩童，PioFluMet化疗中会和化疗后的比施打避孕药的好。介入只能靠孩童睾酮相当多的减小因素化疗后的表改型。在孩童，PioFluMet相似的介入这样一来防范成年大部分睾酮相当多的表改型，仅限于肥胖症和生育能力偏颇高。与肝炎相关的拓展阅读：

Diabetes Care：肝炎与心衰病患脑干交感神经活性减小相关Diabetes Care：lixisenatide直接改善二甲双亚胺控制不佳的2改型肝炎许多人的浓度2013 NIH 胎儿期肝炎(GDM)确诊刊出声明JAMA：褪黑激素分泌减愈来愈少减小II改型肝炎高风险DIABETES CARE：短时间浓度筛查胎儿肝炎添新证Eur J Endocrinol: 1改型肝炎病患HbA1c极低水平过颇高能直接引发抑郁愈来愈多信息商量浏览：有关肝炎愈来愈多资讯

Oral Contraception vs Insulin Sensitization for 18 Months in Nonobese Adolescents With Androgen Excess: Posttreatment Differences in C-Reactive Protein, Intima-Media Thickness, Visceral Adiposity, Insulin Sensitivity, and Menstrual Regularity BackgroundAn oral estro-progestagen is the standard medication given to adolescent girls with androgen excess, even when those girls are not at risk of pregnancy. AimThe aim of this study was to compare on-treatment and post-treatment effects of intervention with an oral contraceptive vs an insulin-sensitizing treatment for androgen excess in nonobese adolescents. DesignThis was a randomized, open-label trial. Study PopulationSubjects were nonobese adolescent girls with hyperinsulinemic androgen excess and without risk of pregnancy (mean age, 16 years; body mass index, 23 kg/m2; n = 34). InterventionsThe effects of treatment with ethinylestradiol-cyproteroneacetate (EE-CA) vs a low-dose combination of pioglitazone (7.5 mg/d), flutamide (62.5 mg/d), and metformin (850 mg/d) (PioFluMet) for 18 months were studied. Posttreatment follow-up was for 6 months. Main Outcome MeasuresAndrogen excess (hirsutism and acne scores and serum testosterone), glucose-stimulated insulinemia, circulating C-reactive protein, carotid intima media thickness, body composition (absorptiometry), abdominal fat partitioning (magnetic resonance imaging), and menstrual regularity were measured. ResultsEE-CA and PioFluMet attenuated androgen excess similarly but had divergent, and even opposing, effects on other outcomes. Six months posttreatment, the PioFluMet-treated girls had a lower glucose-induced insulinemia, a lower C-reactive protein level, and a thinner intima media than the EE-CA–treated girls, and they were viscerally less adipose, had a higher lean mass, and were more likely to he regular cycles. ConclusionsThe on-treatment and post-treatment effects of PioFluMet compared forably with those of oral contraception in nonobese adolescents with androgen excess. The intervention whereby androgen excess is reduced in adolescence influences the post-treatment phenotype. PioFluMet-like interventions in adolescence may thus hold the potential to prevent part of the androgen-excess phenotype in hood, including adiposity and subfertility.