Role of Dehydroepiandrosterone Sulfate as a Prehormone for Ovarian Steroidogenesis
Role of Dehydroepiandrosterone Sulfate as a Prehormone for Ovarian Steroidogenesis
复制标题
硫酸脱氢表雄酮作为激素前体对卵巢类固醇生成的作用
作者：
R. Haning;C. Austin;I. Carlson;D. L. Kuzma;W. Zweibel
在 43 名患者中研究了促性腺激素诱导排卵对内分泌的影响：其中 11 名患者患有下丘脑性闭经，32 名患者患有多囊卵巢综合征。与下丘脑闭经患者相比，多囊卵巢综合征患者血清卵泡刺激素（FSH）、黄体生成素（LH）、17β-雌二醇、硫酸脱氢表雄酮、睾酮基线值较高，无睾酮指数较高。促性腺激素治疗期间，多囊卵巢综合征患者的血清LH、催乳素、硫酸脱氢表雄酮、睾酮、游离睾酮百分比、无睾酮指数、体重均高于下丘脑闭经患者；下丘脑性闭经患者的血清FSH、每公斤体重促性腺激素的剂量以及总卵泡体积均高于多囊卵巢综合征患者。对数变换后的多元线性回归表明，无睾酮指数可通过卵巢总体积和硫酸脱氢表雄酮进行统计预测，血清17β-雌二醇可通过卵巢总体积和无睾酮指数进行统计预测。在六名多囊卵巢综合征患者的促性腺激素中添加地塞米松后，17雌二醇、硫酸脱氢表雄酮、睾酮和无睾酮指数显着降低。与下丘脑闭经患者相比，多囊卵巢综合征患者的内源性血清 LH 和硫酸脱氢表雄酮浓度较高，与较高的血清睾酮浓度、较低的总卵泡体积以及在较低的血清 FSH 和较低的每公斤体重促性腺激素剂量下对促性腺激素的有效反应相关。这些数据表明血清脱氢表雄酮硫酸盐可能是卵巢类固醇生成的前体。
The endocrine effects of induction of ovulation with menotropins were studied in 43 patients: 11 with hypothalamic amenorrhea and 32 with the polycystic ovary syndrome. Patients with polycystic ovary syndrome had higher baseline values of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17β -estradiol, dehydroepiandrosterone sulfate, testosterone, and a higher testosterone-free index than those with hypothalamic amenorrhea. During treatment with menotropins, patients with polycystic ovary syndrome had higher values of serum LH, prolactin, dehydroepiandrosterone sulfate, testosterone, percent free testosterone, testosterone-free index, arid body weight than those with hypothalamic amenorrhea; serum FSH, dose of menotropins per kilogram body weight, and total follicular volume were higher in patients with hypothalamic amenorrhea than in those with polycystic ovary syndrome. Multiple linear regression after log transformation demonstrated that the testosterone-free index was predicted statistically by total ovarian volume and dehydroepiandrosterone sulfate and that serum 17β - estradiol was predicted statistically by total ovarian volume and testosterone-free index. Adding dexamethasone to menotropins in six patients with polycystic ovary syndrome produced significant decreases in 17Pestradiol, dehydroepiandrosterone sulfate, testosterone, and testosterone-free index. Higher concentrations of endogenous serum LH and dehydroepiandrosterone sulfate in patients with polycystic ovary syndrome in comparison with those with hypothalamic amenorrhea were associated with higher concentrations of serum testosterone, a lower total follicular volume, and an effective response to menotropins at a lower serum FSH and a lower dose of menotropins per kilogram body weight. These data suggest that serum dehydroepiandrosterone sulfate may be a precursor for ovarian steroidogenesis.