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健康老年男性生理性夜间催乳素相对分泌减少的机制:催乳素分泌突发量和基础分泌量双重下降,而脉冲持续时间、频率和脉冲间期保持不变——一项综合临床研究中心的研究

Mechanisms subserving the physiological nocturnal relative hypoprolactinemia of healthy older men: dual decline in prolactin secretory burst mass and basal release with preservation of pulse duration, frequency, and interpulse interval--a General Clinical Research Center study.

作者信息

Iranmanesh A, Mulligan T, Veldhuis J D

机构信息

Endocrine Section, Medical Service, Salem Veterans Affairs Medical Center, Virginia 24153, USA.

出版信息

J Clin Endocrinol Metab. 1999 Mar;84(3):1083-90. doi: 10.1210/jcem.84.3.5514.

DOI:10.1210/jcem.84.3.5514
PMID:10084599
Abstract

Increasing age is accompanied by decrements in randomly obtained, fasting, or frequently sampled serum PRL concentrations. The precise neuroendocrine mechanisms underlying such relative hypoprolactinemia in aging are incompletely understood. In the present study, we sampled blood at 2.5-min intervals overnight in 11 young (aged 21-34 yr) and 8 older (aged 62-72 yr) healthy men for subsequent chemiluminescence-based assay of serum PRL concentrations. The mean (+/- SEM) serum PRL concentration was significantly reduced at 4.3 +/- 0.78 microg/L in older men compared with 9.5 +/- 1.2 microg/L in young volunteers (P = 0.0049). PRL concentrations correlated with serum testosterone (r = 0.473; P = 0.041), dehydroepiandrosteroen sulfate (r = +0.455, P = 0.05), and insulin-like growth factor I (r = 0.494; P = 0.032) levels. Deconvolution analysis was used to evaluate combined pulsatile and basal modes of PRL secretion. In older men, discrete PRL secretory bursts were marked by a significantly (2.4-fold) attenuated mass of hormone secreted per burst (amount of PRL secreted per unit distribution volume), viz. 1.6 +/- 0.23 (older) vs. 3.9 +/- 0.57 microg/L (young; P < 0.01). In contrast, PRL secretory burst frequency, interpulse interval, and pulse duration were invariant of age. Concomitantly, basal PRL secretion was reduced by 2-fold in older subjects, namely to 0.00030 +/- 0.00027 (older) vs. 0.00065 +/- 0.0002 microg/L/min (young; P < 0.01). The amount of total PRL secretion that was pulsatile averaged 82 +/- 5.3% in young and 99 +/- 0.13% in older men (P = 0.012), indicating preferential loss of the basal mode of PRL release in aging. Assuming that basal PRL secretion mirrors functional pituitary lactotroph cell secretory mass, whereas pulsatile PRL release reflects effective (net) intermittent hypothalamic drive to responsive lactotroph cells, then our results suggest both an attrition in lactotroph cell mass and an impoverishment of net positive hypothalamic (agonistic) input to lactotrophs in older men. Given the multiple roles of PRL reported in experimental animals (e.g. on the one hand to support immune function and adrenal androgen biosynthesis and on the other hand to activate intraprostatic growth factors), we suggest that the nocturnal relative hypoprolactinemia observed in healthy aging men may have both adaptive and maladaptive clinical implications to target tissues.

摘要

随着年龄增长,随机获取的、空腹的或频繁采样的血清催乳素(PRL)浓度会下降。衰老过程中这种相对低催乳素血症背后的确切神经内分泌机制尚未完全明确。在本研究中,我们对11名年轻(21 - 34岁)和8名年长(62 - 72岁)健康男性进行了整夜每隔2.5分钟的采血,随后采用基于化学发光法测定血清PRL浓度。年长男性的平均(±标准误)血清PRL浓度显著降低,为4.3±0.78μg/L,而年轻志愿者为9.5±1.2μg/L(P = 0.0049)。PRL浓度与血清睾酮(r = 0.473;P = 0.041)、硫酸脱氢表雄酮(r = +0.455,P = 0.05)以及胰岛素样生长因子I(r = 0.494;P = 0.032)水平相关。反卷积分析用于评估PRL分泌的脉冲式和基础模式的组合。在年长男性中,离散的PRL分泌脉冲以每次脉冲分泌的激素量显著(2.4倍)减少为特征(每单位分布体积分泌的PRL量),即1.6±0.23(年长)对3.9±0.57μg/L(年轻;P < 0.01)。相比之下,PRL分泌脉冲频率、脉冲间期和脉冲持续时间不受年龄影响。同时,年长受试者的基础PRL分泌减少了2倍,即降至0.00030±0.00027(年长)对0.00065±0.0002μg/L/分钟(年轻;P < 0.01)。年轻男性中脉冲式PRL分泌总量平均为82±5.3%,年长男性为99±0.13%(P = 0.012),表明衰老过程中PRL释放的基础模式优先丧失。假设基础PRL分泌反映功能性垂体催乳素细胞的分泌量,而脉冲式PRL释放反映下丘脑对反应性催乳素细胞的有效(净)间歇性驱动,那么我们的结果表明年长男性中催乳素细胞量减少以及下丘脑对催乳素细胞的净正性(激动性)输入减少。鉴于实验动物中报道的PRL的多种作用(例如一方面支持免疫功能和肾上腺雄激素生物合成,另一方面激活前列腺内生长因子),我们认为在健康衰老男性中观察到的夜间相对低催乳素血症可能对靶组织具有适应性和非适应性的临床意义。

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