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健康老年男性中黄体生成素释放与促卵泡激素、催乳素及夜间阴茎勃起(NPT)振荡之间的青年同步性破坏。

Disruption of the young-adult synchrony between luteinizing hormone release and oscillations in follicle-stimulating hormone, prolactin, and nocturnal penile tumescence (NPT) in healthy older men.

作者信息

Veldhuis J D, Iranmanesh A, Mulligan T, Pincus S M

机构信息

Department of Internal Medicine, National Science Foundation Center for Biological Timing, University of Virginia Health Sciences Center, Charlottesville 22908, USA.

出版信息

J Clin Endocrinol Metab. 1999 Oct;84(10):3498-505. doi: 10.1210/jcem.84.10.6100.

DOI:10.1210/jcem.84.10.6100
PMID:10522986
Abstract

The healthy human male hypothalamo-pituitary-gonadal axis exhibits age-dependent loss of coordinate LH-testosterone secretion. A putative independent defect in Leydig-cell steroidogenesis with aging would confound the attribution of such LH-testosterone asynchrony to a hypothalamo-pituitary locus per se. Accordingly, here we appraise by sampling every 2.5 min overnight the joint synchrony of moment-to-moment LH release with simultaneously monitored pituitary FSH secretion, prolactin release, and nocturnal penile tumescence (NPT) oscillations, as a neurophysiological correlate of sleep regulation) in 10 young (ages 21-34) and 8 older (ages 62-72) healthy men. Joint synchrony for paired LH-FSH, LH-prolactin, and LH-NPT observations in young vs. older individuals was quantified by the cross-approximate entropy (cross-ApEn) statistic, with larger cross-ApEn values indicating greater two-variable asynchrony. Concomitantly, we assessed (possible) univariate changes with age for each of LH, FSH, prolactin, and NPT, as quantified by approximate entropy (ApEn). Hormone assays were performed by random-access direct chemiluminescence analyzer. Overnight mean (+/- SEM) serum LH concentrations (IU/L) were equivalent in older (3.1 +/- 0.31 IU/L) and younger (2.9 +/- 0.29) men, as were their serum total testosterone concentrations; viz., 425 +/- 48 (older) and 523 +/- 40 (younger) ng/dL. However, all three sets of paired time-series were significantly more asynchronous in the older cohort. First, cross-ApEn of paired LH-FSH release was significantly higher (or more asynchronous) in older subjects; viz., 1.902 +/- 0.022 in older men vs. 1.607 +/- 0.058 in younger individuals (P = 0.0005). Second, cross-ApEn of paired LH and prolactin release was 1.744 +/- 0.085 in older volunteers vs. 1.346 +/- 0.084 in younger subjects (P = 0.0046). Third, and most notably, cross-ApEn for the joint LH-NPT observation time-series was significantly greater in older subjects at 1.771 +/- 0.056 vs. 1.223 +/- 0.086 (young) (P = 0.0001), thereby denoting loss of coordination between (neural) signals directing intermittent LH secretion and those governing sleep-associated penile tumescence in older men. Among one-variable results, only ApEn of LH release was significantly higher in older individuals at 1.323 +/- 0.058 vs. 0.897 +/- 0.089 in younger subjects (P = 0.0019), signifying greater disorderliness of the LH secretory process in aged men. Individual ApEn values of FSH and prolactin release and NPT were age-invariant. In ensemble, the present clinical experiments indicate that, within the aging male reproductive axis, bihormonal network disruption is more pronounced than individual signal disruption. We suggest that abrogation of joint synchrony among hypothalamically directed pituitary hormones and a neurogenically organized sexual response (nocturnal penile tumescence) can be unified thematically under an hypothesis of disrupted central nervous system hypothalamo-pituitary network coordination in human aging. Such implicit disarray of multinodal communication is of consequence both scientifically and clinically, especially in proposing aging theories and intervention strategies.

摘要

健康男性的下丘脑 - 垂体 - 性腺轴表现出随年龄增长而出现的促黄体生成素(LH) - 睾酮分泌协调功能丧失。随着年龄增长,睾丸间质细胞类固醇生成中可能存在的独立缺陷会使将这种LH - 睾酮不同步归因于下丘脑 - 垂体本身的位点变得复杂。因此,我们在此通过在夜间每隔2.5分钟进行一次采样,评估10名年轻(21 - 34岁)和8名年长(62 - 72岁)健康男性中LH即时释放与同时监测的垂体促卵泡生成素(FSH)分泌、催乳素释放以及夜间阴茎勃起(NPT)振荡的联合同步性,将其作为睡眠调节的神经生理学关联指标。通过交叉近似熵(cross - ApEn)统计量对年轻个体与年长个体中LH - FSH、LH - 催乳素和LH - NPT配对观察的联合同步性进行量化,交叉ApEn值越大表明两个变量的不同步性越大。同时,我们通过近似熵(ApEn)评估LH、FSH、催乳素和NPT各自随年龄的(可能的)单变量变化。激素检测通过随机接入直接化学发光分析仪进行。年长男性(3.1±0.31 IU/L)和年轻男性(2.9±0.29 IU/L)的夜间平均(±标准误)血清LH浓度(IU/L)相当,他们的血清总睾酮浓度也相当;即,年长男性为425±48 ng/dL,年轻男性为523±40 ng/dL。然而,在年长队列中,所有三组配对时间序列的不同步性明显更大。首先,年长受试者中LH - FSH释放的交叉ApEn显著更高(或不同步性更大);即,年长男性为1.902±0.022 vs.年轻个体为1.607±0.058(P = 0.0005)。其次,年长志愿者中LH与催乳素释放的交叉ApEn为1.744±0.085,而年轻受试者为1.346±0.084(P = 0.0046)。第三,也是最显著的,年长受试者中LH - NPT联合观察时间序列的交叉ApEn显著更大,为1.771±0.056 vs.年轻受试者的1.223±0.086(P = 0.0001),这表明在年长男性中,指导间歇性LH分泌的(神经)信号与控制睡眠相关阴茎勃起的信号之间失去了协调性。在单变量结果中,只有年长个体中LH释放的ApEn显著更高,为1.323±0.058 vs.年轻受试者的0.897±0.089(P = 0.0019),这表明老年男性中LH分泌过程的无序性更大。FSH和催乳素释放以及NPT的个体ApEn值不随年龄变化。总体而言,目前的临床实验表明,在衰老的男性生殖轴中,双激素网络破坏比个体信号破坏更为明显。我们认为,下丘脑定向的垂体激素与神经源性组织的性反应(夜间阴茎勃起)之间联合同步性的丧失可以在人类衰老过程中中枢神经系统下丘脑 - 垂体网络协调破坏的假设下进行主题性统一。这种多节点通信的隐含紊乱在科学和临床上都具有重要意义,特别是在提出衰老理论和干预策略方面。

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