JCEM：青少年胰岛素增敏治疗可卫生保健成年雄激素过多的表型

EE-CA和PioFluMet疗程中会和疗程后CRP、CIMT、脾脏脂肪组织和MSI变化

本品雌激素是极多女荷尔蒙以致于的标准疗程，即使当这些**没有更年期的风险。为了相当孕酮与本品增敏疗程介入非老年人青极多年，在疗程中会和疗程后对荷尔蒙以致于的冲击，来自巴萨罗那大学Sant Joan de Deu医务人员肾脏科的Lourdes Ibanez教授及其团队顺利完成了一项数据分析，该数据分析发现青极多年本品增敏疗程介入有可能卫生保健成体以外荷尔蒙以致于特异性。该数据分析结果该网站发表在2012年4翌年1日的美国《临床肾脏激素杂志》（The journal of clinical endocrinology Company metabolism）上。该数据分析是一项随机非盲试验，病患是高本品血症候群和荷尔蒙以致于的非老年人极多女，且没有更年期的风险（34例；半数16岁；肥胖股票价格：23kg/m2）。数据分析相当炔雌醇醋酸环丙孕酮（EE-CA）与小剂量吡咯列酮（7.5mg/d）、氟他迦南人（62.5mg/d）和二甲双苯甲酸（850mg/d）联合（PioFluMet）疗程18个翌年的。疗程后随访6翌年。测量荷尔蒙以致于（疣症候群、痤疮分数和血清睾酮），刺激后本品，周而复始C催化肽，头动脉小肠底厚度，双脚组成（吸收测量法），腹部脂肪组织分区（放射激光）和翌年经周期。该数据分析相比较，EE-CA和PioFluMet同样缓解荷尔蒙以致于，但有差异，以致冲击其他结果。疗程后6个翌年，PioFluMet疗程的**比EE-CA疗程的**有越来越低的刺激后本品，越来越低的C催化肽高水平和越来越薄的小肠底，并且他们的脾脏脂肪组织较极多，带有越来越高的纤肥胖，以及越来越有可能有规律的翌年经周期。该数据分析发现，在非老年人的荷尔蒙以致于的青极多年，PioFluMet疗程中会和疗程后的比孕酮的好。介入缺少青极多年荷尔蒙以致于的减缓冲击疗程后的特异性。在青极多年，PioFluMet相似的介入有可能卫生保健成体以外荷尔蒙以致于的特异性，有数老年人和生育能力低下。与心血管疾病相关的开拓阅读：

Diabetes Care：心血管疾病与心衰症候群状心脏迷走神经活性减缓相关Diabetes Care：lixisenatide有效改善二甲双苯甲酸压制不佳的2改进型心血管疾病人群的体温2013 NIH 断奶心血管疾病(GDM)病患通告JAMA：褪黑激素分泌减极多增加II改进型心血管疾病风险DIABETES CARE：空腹体温侵入性更年期心血管疾病添新证Eur J Endocrinol: 1改进型心血管疾病症候群状HbA1c高水平过高能这样一来造成抑郁越来越多信息再三点击：有关心血管疾病越来越多资讯

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.