DISSOCIATION OF ADRENARCHE AND GONADARCHE IN PRECOCIOUS PUBERTY AND IN ISOLATED HYPOGONADOTROPIC HYPOGONADISM
DISSOCIATION OF ADRENARCHE AND GONADARCHE IN PRECOCIOUS PUBERTY AND IN ISOLATED HYPOGONADOTROPIC HYPOGONADISM
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DOI：
10.1210/jcem-64-6-1174
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发表时间：
1987-06-01
影响因子：
5.8
通讯作者：
CUTLER, GB
中科院分区：
文献类型：
--
作者：
COUNTS, DR;PESCOVITZ, OH;CUTLER, GB
肾上腺原癌是肾上腺的一种发育变化，导致肾上腺雄激素分泌增加。这种成熟过程通常在下丘脑-垂体-性腺轴(性腺)激活前几年开始。为了进一步研究肾上腺素和性腺激素的关系，我们检测了性早熟患者和单纯性腺激素低减患者的肾上腺激素水平。本文测定了50例性早熟儿童、5例单纯性腺激素减退症、7例体格矮小的肾上腺前期儿童、44例正常青春期儿童和40例正常成人的基础血浆脱氢表雄酮、脱氢表雄酮硫酸盐、雄烯二酮和皮质醇。青春期早熟的儿童在肾上腺发育时间上没有相应的提前。他们的基础肾上腺雄激素水平和ACTH刺激的肾上腺雄激素水平明显低于与青春期匹配的正常儿童(P<；0.05)，仅略高于报道的同龄正常儿童的水平。同样，单纯性低促性腺激素减退症和青春期延迟的患者没有相应的肾上腺发育迟缓。他们的肾上腺雄激素水平与实际年龄相符。因此，这些数据进一步支持了肾上腺和性腺是由不同机制控制的独立成熟事件的假说。
Adrenarche is a developmental change of the adrenal gland that results in increased secretion of adrenal androgens. This maturational process generally begins several years before activation of the hypothalamic-pituitary-gonadal axis (gonadarche). To study further the relationship between adrenarche and gonadarche, we examined adrenarche in patients with precocious puberty and in patients with isolated hypogonadotropic hypogonadism. Plasma dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and cortisol were measured basally and during an infusion of ACTH in 50 children with precocious puberty, 5 patients with isolated hypogonadotropic hypogonadism, 7 preadrenarchal children with constitutional short stature, 44 normal pubertal children, and 40 normal adults. Children with precocious puberty did not have a corresponding advance in the timing of adrenarche. Their basal and ACTH-stimulated adrenal androgen levels were markedly lower than those of normal children matched for pubertal stage (P < 0.05) and were only slightly greater than those reported for normal children of the same age. Similarly, patients with isolated hypogonadotropic hypogonadism and delayed puberty had no corresponding delay of adrenarche. Their adrenal androgen levels were appropriate for chronological age. Thus, these data provide further support for the hypothesis that adrenarche and gonadarche are independent maturational events controlled by separate mechanisms.