ALTERATIONS IN THE HYPOTHALAMIC-PITUITARY-OVARIAN AND THE HYPOTHALAMIC-PITUITARY-ADRENAL AXES IN ATHLETIC WOMEN
ALTERATIONS IN THE HYPOTHALAMIC-PITUITARY-OVARIAN AND THE HYPOTHALAMIC-PITUITARY-ADRENAL AXES IN ATHLETIC WOMEN
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DOI：
10.1210/jcem-68-2-402
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发表时间：
1989-02-01
影响因子：
5.8
通讯作者：
YEN, SSC
中科院分区：
文献类型：
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作者：
LOUCKS, AB;MORTOLA, JF;YEN, SSC
通过测定具有规律月经周期的运动型女性（CA; n = 9）、闭经的运动型女性（AA; n = 9）和规律周期性久坐的女性（CS; n = 8）在卵泡早期的脉动LH、ACTH和皮质醇分泌来评估下丘脑-垂体-卵巢和下丘脑-垂体-肾上腺轴的功能完整性。CA和AA妇女在身体成分、运动训练、心理测试或饮食消费方面没有显著差异。 CA组黄体期短于CS组（P < 0.05），尿中妊娠葡萄糖醛酸苷排泄量低于CS组。在AA妇女中，尿雌酮葡萄糖醛酸苷、孕激素葡萄糖醛酸苷和LH排泄在30天内均较低。CA妇女24小时LH脉冲式分泌的特征是频率降低（P < 0.05）和幅度增加（P < 0.05），导致24小时平均水平总体增加（P < 0.05），但脉冲间期与CS妇女相似。在睡眠期间，CS和CA妇女LH脉冲频率减慢，而脉冲幅度增加，两组的平均血清LH水平下降。AA女性在更多变（P <0.01）的脉冲间期出现更少的正常幅度脉冲（P <0.05）。睡眠相关的LH脉动性变化不存在。对10 μ g促性腺激素释放激素推注剂量的反应显示CA中FSH释放减弱（P < 0.05），AA妇女中LH释放增加（P < 0.05）。各组在任何24小时ACTH脉冲模式参数或皮质醇脉冲频率方面没有差异。然而，两组运动员的清晨（0200-0800 h）血清皮质醇水平均较高（P < 0.05），AA女性的这种升高持续到白天（0800-2000 h; P < 0.001）和晚上（2000-0200 h; P < 0.05）。在CA和AA妇女中，对推注人CRH施用的血浆ACTH和血清皮质醇反应是钝化的[从基线的变化（Δ C）]。ACTH，P < 0.05和P < 0.01;皮质醇，分别为P < 0.01和P < 0.01]，但肾上腺敏感性（Δ。皮质醇/ΔACTH比值升高（P < 0.05）。运动组血浆ACTH和血清皮质醇对膳食的反应也减弱（P < 0.05）。这些结果表明，在何种程度上下丘脑-垂体-肾上腺轴的周期性和amphalorheic运动员的干扰是相关的，也许是因果关系，与他们的下丘脑-垂体-卵巢轴异常。
The functional integrity of the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes was assessed by determining pulsatile LH, ACTH, and cortisol secretion during the early follicular phase in athletic women with regular menstrual cycles (CA; n = 9), athletic women with amenorrhea (AA; n = 9), and regularly cyclic sedentary women (CS; n = 8). The CA and AA women were not significantly different in body composition, exercise training, psychometric tests, or dietary consumption. The CA women had shorter luteal phases (P < 0.05) and lower urinary excretion of pregnanediol glucuronide than the CS women. In the AA women, urinary estrone glucuronide, pregnanediol glucuronide, and LH excretion were low throughout a 30-day period. The CA women had a 24-h pattern of pulsatile LH secretion characterized by reduced frequency (P < 0.05) and increased amplitude (P < 0.05), yielding an overall increased 24-h mean level (P < 0.05), but interpulse intervals similar to those in the CS women. During sleep, LH pulse frequency slowed in the CS and CA women, while pulse amplitude increased and the mean serum LH level decreased in both groups. The AA women had even fewer pulses (P < 0.05) of normal amplitude occurring at much more variable (P < 0.01) interpulse intervals. Sleep-associated changes in LH pulsatility were absent. Responses to a 10-.mu.g bolus GnRH dose revealed blunted (P < 0.05) FSH release in CA and augmented (P < 0.05) LH release in AA women. The groups did not differ in any 24-h ACTH pulse pattern parameter or in cortisol pulse frequencies. Yet, early morning (0200-0800 h) serum cortisol levels were higher (P < 0.05) in both groups of athletes, and this elevation was extended through the day (0800-2000 h; P < 0.001) and evening (2000-0200 h; P < 0.05) in the AA women. The plasma ACTH and serum cortisol responses to bolus human CRH administration were blunted in the CA and AA women [change from baseline (.DELTA. in ACTH, P < 0.05 and P < 0.01; .DELTA. cortisol, P < 0.01 and P < 0.01, respectively], but adrenal sensitivity (.DELTA. cortisol/.DELTA. ACTH ratio) was increased (P < 0.05). The plasma ACTH and serum cortisol repsonses to meals also were blunted in the athletic groups (P < 0.05). These results indicate that the degree to which the hypothalamic-pituitary-adrenal axis is disturbed in cyclic and amenorrheic athletes is associated, perhaps causally, with their hypothalamic-pituitary-ovarian axis abnormalities.