睡眠時無呼吸症候群を伴う高度肥満児1例におけるレプチン値日内変動(東京女子医科大学東医療センター小児科開局40周年記念論文集)

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We studied the circadian rhythm of leptin secretion before and after obesity therapy, in a preadolescent boy who succeeded in dieting. A 9 year-old boy with sleep apnea syndrome had an obesity index of 120% before treatment. From 09:00 on the examination day until 09:00 the next morning, we collected blood every 3 hr. We studied serum leptin, melatonin, and cortisol. His serum leptin and melatonin circadian rhythms were assessed again after weight reduction by diet and exercise, while treating sleep apnea using continuous positive nasal air pressure (CPAP). Leptin averaged 40.6ng/ml before dieting, peaking at 63.8ng/ml at 03:00. Melatonin was low at night. Cortisol was 11.4μg/dl at 00:00. After dieting and CPAP, average leptin decreased to 18.7ng/ml. The daily maximum difference in his leptin circadian rhythm was 36ng/ml before weight loss and 8ng/ml after treatment. In our study, average leptin decreased in apparent accordance with the body fat decrease. Nocturnal leptin hyper secretion decreased markedly after obesity treatment. In conclusion, our observations suggest that hypoxia with sleep apnea may stimulate nocturnal leptin secretion and affect the circadian rhythm of leptin secretion.
東京女子医科大学の論文
2007-05-31