JCEM：青少年胰岛素增敏治疗可预防刚出生雄激素过多的表型

EE-CA和PioFluMet疗法中会和疗法后CRP、CIMT、内脏脂肪和MSI变化

口服雌孕激素是少女代谢物但会的新标准疗法，即使当这些男人不能妊娠的可能会。为了非常孕酮与胰岛素增敏疗法干预非心血管疾病少年儿童，在疗法中会和疗法后对代谢物但会的制约，来自巴萨罗那大学Sant Joan de Deu公立医院内分泌科的Lourdes Ibanez教授及其制作团队开展了一项数据分析，该数据分析推测少年儿童胰岛素增敏疗法干预无论如何预防成年均代谢物但会变异。该数据分析结果在线刊登在2012年4月1日的美国《临床数据分析内分泌代谢杂志》（The journal of clinical endocrinology Andrew metabolism）上。该数据分析是一项随机非盲试验，受试者是极低胰岛素血病症和代谢物但会的非心血管疾病少女，且不能妊娠的可能会（34由此可知；总人数16岁；体重指数：23kg/m2）。数据分析非常炔雌醇丙酮环丙孕酮（EE-CA）与小剂量吡咯列酮（7.5mg/d）、氟他米特（62.5mg/d）和二甲双亚胺（850mg/d）牵头（PioFluMet）疗法18个月的。疗法后随访6月。校准代谢物但会（粗毛病症、痤疮分数和血清激素），诱导后胰岛素，周而复始C反应蛋白，颈动脉内膜中会层尺寸，身体组成（释放出来校准法），腹部脂肪分区（核磁共振成像）和月经周期。该数据分析结果表明，EE-CA和PioFluMet比方说缓解代谢物但会，但有不同，以致制约其他结果。疗法后6个月，PioFluMet疗法的男人比EE-CA疗法的男人有更为极低的诱导后胰岛素，更为极低的C反应蛋白总体和更为细的内膜中会层，并且他们的内脏脂肪较少，具有更为极低的瘦体重，以及更为无论如何有规律的月经周期。该数据分析推测，在非心血管疾病的代谢物但会的少年儿童，PioFluMet疗法中会和疗法后的比孕酮的好。干预倚靠少年儿童代谢物但会的增高制约疗法后的变异。在少年儿童，PioFluMet相似的干预无论如何预防成年均代谢物但会的变异，包括心血管疾病和不育大幅提极低。与肝炎相关的扩充阅读：

Diabetes Care：肝炎与心衰患者瓣膜神经活性增高相关Diabetes Care：lixisenatide有效提升二甲双亚胺控制不佳的2新标准型肝炎许多人的胰岛素2013 NIH 妊娠期肝炎(GDM)检验声明JAMA：褪黑激素分泌增高增加II新标准型肝炎可能会DIABETES CARE：空腹胰岛素筛查妊娠肝炎添新证Eur J Endocrinol: 1新标准型肝炎患者HbA1c总体过极低能直接导致焦虑病症更为多信息叮嘱浏览者：有关肝炎更为多资讯

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.