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Abnormalities in Puberty - part 4

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Ảnh hưởng rộng rãi mang lại lợi ích của 9 tháng kết hợp flutamide-metformin (Flu-Met) điều trị ở các bé gái pubarche sớm với hyperandrogenism buồng trứng (n 30, tuổi trung bình là 15,8 năm), và suy thoái tiếp theo ngưng | Hirsutism score Testosterone ng dl Androstenedione ng dl DHEAS g dl Insulin sensitivity HOMA HDL-cholesterol mg dl LDL-cholesterol mg dl Triglycerides mg dl Waist-to-hip ratio Abdominal fat mass kg Body fat mass kg Lean body mass kg -3 0 3 6 9 12months -3 0 3 6 9 12months -3 0 3 6 9 12months -3 0 3 6 9 12months Fig. 2. Widespread beneficial effects of 9 months combined flutamide-metformin Flu-Met treatment in precocious pubarche girls with ovarian hyperandrogenism n 30 mean age 15.8 years and subsequent deterioration on discontinuation n 16 . p 0.0001 vs. 0 months n 30 Ip 0.01 vs. 9 months or p 0.001 vs. 9 months n 16 . None of the 3 vs. 0 month differences reached statistical significance n 14 . Reproduced from Ibanez et al. 108 . prevent progression to overt PCOS 110 . These precocious pubarche girls were selected for low birthweight 2.4kg at term and therefore high risk of progression. Over the 12 month study in untreated girls features of insulin resistance hyperandrogenemia dyslipidemia excess truncal fat and reduced lean body mass all continued to diverge further away from normal conversely in metformin-treated girls all these abnormalities showed significant improvements. Such positive results have encouraged the study of even earlier treatment strategies at or soon after the onset of precocious pubarche mean age 8.0 years with low-dose metformin 425 mg daily after 6 months significant beneficial effects have been observed on adrenal androgen levels lipid profiles reduced total and abdominal fat mass and increased lean body mass 94 . Adrenal Function of Low-Birthweight Children 47 This is trial version www.adultpdf.com Conclusions The apparent consequences of low birthweight on later increases in both adrenal cortisol and adrenal androgen production may impact not only pubertal development but they may also contribute to the longer-term disease risks described by studies of the fetal origins of adult disease. Further studies are needed to identify the .