LONGITUDINAL EVALUATION OF THE DIFFERENT GONADOTROPIN PULSATILE PATTERNS IN ANOVULATORY CYCLES OF YOUNG GIRLS
LONGITUDINAL EVALUATION OF THE DIFFERENT GONADOTROPIN PULSATILE PATTERNS IN ANOVULATORY CYCLES OF YOUNG GIRLS
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DOI：
10.1210/jc.74.4.836
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发表时间：
1992-04-01
影响因子：
5.8
通讯作者：
FLAMIGNI, C
中科院分区：
文献类型：
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作者：
VENTUROLI, S;PORCU, E;FLAMIGNI, C
我们研究了13名有排卵周期的青少年（平均妇科年龄29.2 +/- 14.1个月）和7名有排卵周期的女性（平均妇科年龄33.1 +/- 15.3个月）作为对照组。无排卵周期的青少年根据平均血浆LH值分组：1组（n = 7） LH值高，2组（n = 6） LH值正常。所有女性的血浆促性腺激素浓度在月经周期的第4天每隔10分钟测量8小时。40个月后，对每名受试者进行第二次脉动性促性腺激素分泌的研究，以确定不同脉动模式的结果。1组的黄体生成素脉冲比其他两组更频繁和更大（两者相似），血浆中17- β雌二醇、睾酮、雄烯二酮和17羟孕酮浓度最高。纵向对照显示：1组7个受试者中有3个获得了排卵周期，平均LH水平下降（30 +/- 5 vs 9 +/- 4 IU/L, P < 0.01），脉冲数下降（8.3 +/- 1.5 vs 5 +/- 0, P < 0.025），平均振幅下降（13 +/- 3 vs 5 +/- 2 IU/L, P < 0.02），脉间间隔增加（56 +/- 10 vs 91 +/- 6 min, P < 0.01）。在四名受试者中，无排卵周期持续存在，LH脉动谱保持不变。在组2中，6个受试者中有5个获得了排卵周期，但脉冲数（6 +/- 1 vs. 6 +/- 2; P = NS）、脉冲间隔（97 +/- 30 vs. 85 +/- 30 min; P = NS）或振幅（5 +/- 2 vs. 4 +/- 2 IU/L; P = NS）没有显著变化。结果表明：1)早期血浆LH值正常的无排卵年轻女性GnRh脉动模式充足，容易导致排卵；2)黄体生成素高的无排卵年轻女性在病理状态下可能存在生殖系统阻塞，类似于多囊卵巢综合征；3)由于GnRh释放的新模式，只有少数高血浆LH值的受试者能够实现排卵并使LH脉冲模式正常化。
We studied 13 adolescents (mean gynecological age 29.2 +/- 14.1 months) with anovulatory cycles and 7 women with ovulatory cycles (mean gynecological age 33.1 +/- 15.3 months) as a control group.Adolescents with anovulatory cycles were grouped on the basis of mean plasma LH values: group 1 (n = 7) with high LH values, and group 2 (n = 6) with normal LH values.In all women plasma gonadotropin concentrations were measured at 10-min intervals for 8 h on day 4 of the cycle. Pulsatile gonadotropin secretion was also studied in each subject a second time 40 months later, to establish the outcome of the different pulsatile patterns.Group 1 had more frequent and greater LH pulses than the other two groups (which were similar) and had the highest plasma 17-beta estradiol, testosterone, androstenedione, and 17 hydroxyprogesterone concentrations.Longitudinal control showed that: in group 1, three subjects out of seven acquired ovulatory cycles and there was a fall in mean LH plasma levels (30 +/- 5 vs. 9 +/- 4 IU/L; P < 0.01), number of pulses (8.3 +/- 1.5 vs. 5 +/- 0; P < 0.025), mean amplitude (13 +/- 3 vs. 5 +/- 2 IU/L; P < 0.02) and an increase in interpulse interval (56 +/- 10 vs. 91 +/- 6 min; P < 0.01). In four subjects anovulatory cycles persisted and the LH pulsatile profile remained unchanged.In group 2, five subjects out of six acquired ovulatory cycles, but there were no significant changes in the number of pulses (6 +/- 1 vs. 6 +/- 2; P = NS), interpulse interval (97 +/- 30 vs. 85 +/- 30 min; P = NS), or amplitude (5 +/- 2 vs. 4 +/- 2 IU/L; P = NS).The results indicate that: 1) anovulatory young women with early normal plasma LH values have an adequate GnRh pulsatile pattern which will easily lead to ovulation; 2) anovulatory young women with high LH plasma values may have a reproductive system blocked in a pathological condition, similar to that observed in polycystic ovary syndrome; 3) only few subjects with high plasma LH values are able to achieve ovulation and normalize LH pulsatile pattern as a consequence of a new mode of GnRh release.