The pituitary-gonadal axis in men with protein-calorie malnutrition.
The pituitary-gonadal axis in men with protein-calorie malnutrition.
复制标题
蛋白质热量营养不良男性的垂体-性腺轴。
DOI：
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发表时间：
1975
影响因子：
5.8
通讯作者：
Claude J. Migeon
中科院分区：
文献类型：
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作者：
Stephen R. Smith;M. Chhetri;Ann J. Johanson;Nezam Radfar;Claude J. Migeon
在加尔各答的一家医院，对28名患有严重蛋白质-热量营养不良的男性进行了垂体-性腺轴研究。这些人是根据营养不良的严重程度和没有其他疾病而被选中的。他们有性腺功能减退症和低总和未结合血浆睾酮的临床结果。在再喂养2-5个月期间，临床恢复，血浆睾酮增加至正常。血浆LH在营养不良时较高，在再喂养期间下降，再喂养后仍高于正常。部分患者尽管血浆睾酮水平较低，但营养不良患者LH水平未升高。血浆FSH高营养不良，减少再喂养期间，并接近正常的印度男子再喂养后的水平。HCG 4000 IU im每天3天产生低于正常水平的血浆睾酮增量在营养不良和再喂养后，FSH发生相应的下降。它的结论是，性腺功能减退的蛋白质-热量营养不良的基础上减少Leydig细胞的功能。在某些患者中，适当的垂体LH反应是完整的，但在另一些患者中则是不存在或不足的。亚临床Leydig细胞功能不全，表现为LH升高和对HCG反应异常，在重新喂养后营养不良和临床性腺功能减退症恢复后仍持续存在。营养不良时FSH升高可能继发于Leydig细胞功能降低。
The pituitary-gonadal axis was studied in 28 men with severe protein-calorie malnutrition in a Calcutta hospital. The men were selected for the severity of their malnutrition and for absence of other diseases. They had clinical findings of hypogonadism and low total and unbound plasma testosterone. During 2-5 months of refeeding there was clinical recovery and increase of plasma testosterone to normal. Plasma LH was high in malnutrition, decreased during refeeding, and remained above normal after refeeding. Some patients failed to show LH elevation in malnutrition despite low plasma tesosterone. Plasma FSH was high in malnutrition, decreased during refeeding, and was near the level of normal Indian men after refeeding. HCG 4000 IU im per day for 3 days produced subnormal increments in plasma testosterone both in malnutrition and after refeeding; corresponding decreases in FSH occurred. It is concluded that the hypogonadism of protein-calorie malnutrition is primarily on the basis of diminished Leydig cell function. Appropriate pituitary LH response is intact in some patients, but is either absent or inadequate in others. Subclinical Leydig cell insufficiency, indicated by LH elevation and subnormal response to HCG, persists after refeeding has produced recovery from malnutrition and clinical hypogonadism. FSH elevation in malnutrition may be secondary to the reduced Leydig cell function.