Increased adrenal steroid secretion in response to CRF in women with hypothalamic amenorrhea
Increased adrenal steroid secretion in response to CRF in women with hypothalamic amenorrhea
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DOI：
10.1016/s0960-0760(01)00094-2
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发表时间：
2001-09-01
影响因子：
4.1
通讯作者：
Genazzani, AR
中科院分区：
文献类型：
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作者：
Genazzani, AD;Bersi, C;Genazzani, AR
目的：评价下丘脑性闭经妇女对促肾上腺皮质激素释放因子（CRF）或促肾上腺皮质激素的反应性肾上腺类固醇激素分泌。设计：对照临床研究。单位：意大利比萨大学妇产科生殖医学与儿童发育系。患者：15名下丘脑性闭经女性入组本研究。8名正常自行车运动妇女作为对照组。干预：在注射绵羊CRF（0.1 μ g/kg静脉推注）前后或合成ACTH（0.25 mg静脉推注）后采集血样。主要结局指标：ACTH、17-羟孕酮（17 OHPe）、孕酮（P）、脱氢表雄酮（DHEA）、17-羟孕酮（17 OHP）、皮质醇（F）、11-脱氧皮质醇（S）和雄烯二酮（A）的血浆水平。结果：基础血浆浓度的ACTH，皮质醇，11-脱氧皮质醇，DHEA和17 OHPe的患者显着高于对照组，而血浆水平的孕酮和17-OHP的患者显着低于对照组。在闭经妇女中，17-OHPe/DHEA，17-OHPe/17-OHP和11-脱氧皮质醇/皮质醇的比率显著高于对照组，而17-OHP/雄烯二酮，17-OHP/11-脱氧皮质醇的比率显著降低。在促肾上腺皮质激素释放因子试验中，患者血浆ACTH、皮质醇、17-OHP、11-脱氧皮质醇、DHEA和雄烯二酮水平均显著低于对照组。在响应促肾上腺皮质激素，17-OHP，雄烯二酮和雄烯二酮/皮质醇的血浆水平显着高于对照组患者。结论：患有下丘脑性闭经的患者表现出下丘脑-垂体-肾上腺（HPA）轴的激活增加，如较高的基础水平和肾上腺激素对促肾上腺皮质激素释放因子给药的反应增强所示。这些数据表明肾上腺雄激素酶途径可能紊乱。(C)2001爱思唯尔科技有限公司版权所有。
Objective: To evaluate adrenal steroid hormone secretion in response to corticotropin-releasing factor (CRF) or to adrenocorticotropin hormone in women with hypothalamic amenorrhea. Design: Controlled clinical study. Setting: Department of Reproductive Medicine and Child Development, Section of Gynecology and Obstetrics, University of Pisa, Italy. Patient(s): Fifteen women with hypothalamic amenorrhea were enrolled in the study. Eight normal cycling women were used as control group. Intervention(s): Blood samples were collected before and after an injection of ovine CRF (0.1 mug/kg iv bolus) or after synthetic ACTH (0.25 mg iv). Main outcome measure(s): Plasma levels of ACTH, 17-hydroxypregnenolone (17OHPe), progesterone (P), dehydroepiandrosterone (DHEA), 17-hydroxyprogesterone (17OHP), cortisol (F), 11-deoxycortisol (S) and androstenedione (A). Result(s): Basal plasma concentrations of ACTH, cortisol, 11-deoxycortisol, DHEA and 17OHPe were significantly higher in patients than in controls, whereas plasma levels of progesterone and 17-OHP were significantly lower in patients than in controls. In amenorrheic women the ratio of 17-OHPe/DHEA, of 17-OHPe/17-OHP and of 11-deoxycortisol/cortisol were significantly higher than in controls, while a significant reduction in the ratio of 17-OHP/androstenedione, of 17-OHP/11-deoxycortisol was obtained. In response to corticotropin-releasing factor test, plasma levels of ACTH, cortisol, 17-OHP, 11-deoxycortisol, DHEA and androstenedione were significantly lower in patients than in controls. In response to adrenocorticotropin hormone, plasma levels of 17-OHP, androstenedione and androstenedione/cortisol were significantly higher in patients than in controls. Conclusions: Patients suffering for hypothalamic amenorrhea showed an increased activation of hypothalamus-pituitary-adrenal (HPA) axis, as shown by the higher basal levels and by augmented adrenal hormone response to corticotropin-releasing factor administration. These data suggest a possible derangement of adrenal androgen enzymatic pathway. (C) 2001 Elsevier Science Ltd. All rights reserved.