ACTH SENSITIVITY/RESPONSIVITY IN AGING

肾上腺雄激素的产生在患有 高雄激素性少排卵（HO）。 一些调查人员， 包括我们自己在内，都注意到AA过量可能是由于 泛发性肾上腺皮质对促肾上腺皮质激素的高反应性 促肾上腺皮质激素（ACTH）或垂体对促肾上腺皮质激素释放过度反应 激素（CRH）。 这种肾上腺皮质功能障碍可能代表 继发于卵巢雄激素分泌过多的获得性缺陷， 比如睾丸激素 该建议旨在建立敏感性 HO患者对ACTH和CRH的反应性， 肾上腺皮质功能障碍 为了实现这一具体目标， 肾上腺皮质对递增剂量的 促肾上腺皮质激素和绵羊CRH，将在10例HO患者中测定， 10例无肾上腺皮质高反应性的妇女和10例对照妇女。 的 上述研究可以确定垂体高反应性对 HO中的oCRH和/或肾上腺皮质对ACTH的超敏反应可能提示 肾上腺皮质功能障碍在至少50%的HO中明显， 病人是首要的。 此外，它可能暗示了分子机制， 以共同第二信使异常的形式， ACTH受体异常。 如果是这种情况，进一步 需要进行测试以确认这一发现独立于 患者的 荷尔蒙环境 此外，这些发现可能 证明（或不鼓励）在这些患者中使用糖皮质激素抑制是合理的。 妇女

Adrenal androgen production is frequently abnormal in women with hyperandrogenic oligo-ovulation (HO). A number of investigators, including ourselves, have noted that AA excess may result from a generalized adrenocortical hyper-reactivity to adrenocorticotropic hormone (ACTH) or pituitary over-response to corticotropin releasing hormone (CRH). This adrenocortical dysfunction may represent an acquired defect secondary to excessive ovarian secretion of androgens, such as testosterone. This proposal aims to establish the sensitivity and responsivity to ACTH and CRH in HO patients with and without adrenocortical dysfunction. To achieve this specific aim the adrenocortical sensitivity and responsivity to incremental doses of ACTH, and to ovine CRH, will be determined in 10 HO patients with and 10 without adrenocrotical hyperreactivity and in 10 control women. The above studies may identify a role for pituitary hyper-responsivity to oCRH, and/or adrenocortical hypersensitivity to ACTH, in HO may suggest that the adrenocortical dysfunction evident in at least 50% of HO patients is primary. Furthermore, it may suggest molecular mechanisms, either in the form of abnormalities of common secondary messengers or ACTH receptor abnormalities. If this were to be the case, further testing would be needed to confirm that this finding is independent of the patient's hormonal milieu. Furthermore, these findings may justify (or discourage) the use of glucocorticoid suppression in these women.