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老年男性表现出生殖神经激素分泌的多重同步性紊乱。

Older men manifest multifold synchrony disruption of reproductive neurohormone outflow.

作者信息

Veldhuis J D, Iranmanesh A, Godschalk M, Mulligan T

机构信息

Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.

出版信息

J Clin Endocrinol Metab. 2000 Apr;85(4):1477-86. doi: 10.1210/jcem.85.4.6546.

Abstract

Under a working clinical hypothesis that aging putatively disrupts neuroendocrine control mechanisms, here we test a specific corollary notion that transitions in sleep stage, oscillations in nocturnal penile tumescence (NPT; a neurogenically organized signal), and the rates of instantaneous secretion of LH and/or testosterone are jointly synchronous in healthy young, but not older, men. To this end, we evaluated 10 young (aged 21-31 yr) and 8 older (aged 65-74 yr) men by intensive overnight multisite monitoring, viz. simultaneous electro-encephalogram and NPT recordings (every 30 s) and remote blood sampling (every 2.5 min) to quantitate LH and testosterone release. Waveform-independent deconvolution and cross-correlation analyses of these neurohormone outflow measures revealed that healthy young men sustain four salient physiological linkages overnight: 1) a strong inverse (confirmatory) relationship between sleep stage and NPT activity, such that deeper sleep is accompanied by suppression of NPT; 2) consistent coupling between NPT and testosterone secretion, wherein heightened NPT activity respectively precedes and follows increased testosterone secretion by 12.5-32.5 and 50-60 min; 3) evident synchrony between sleep stage and testosterone secretion, in which testosterone secretion increases over a 30-min window (-2.5 to 25 min) while sleep deepens; and 4) a close temporal linkage between instantaneous LH release and NPT oscillations, whereby LH secretion increases 55-62.5 min before and again 5-30 min after NPT declines. In contrast, older men manifested global loss of expected young adult synchrony; namely, 1) abolition of the inverse relationship between sleep stage and NPT, 2) decorrelation of NPT oscillations and testosterone secretion, 3) decoupling of testosterone release and deep sleep, and 4) abrogation of the linkage between LH secretion and penile detumescence. In summary, high intensity overnight monitoring of multiple reproductive neuroendocrine outflow measures simultaneously in young men delineates prominent neurophysiological coupling among sleep transitions and NPT activity, LH and testosterone secretion or NPT oscillations, and testosterone secretion and deepening sleep stage. In contrast, healthy older men exhibit near-universal disruption of physiological young adult synchronicity. Thus, we conclude that male reproductive aging is marked by erosion of coordinate regulation among sleep transitions, central nervous system-directed NPT activity, and hypothalamically driven episodic GnRH/LH (and thereby Leydig cell testosterone) secretion. Whether analogous multifold uncoupling of neurohormone signals emerges in the course of reproductive aging in women or in nonhuman species is not yet known.

摘要

基于衰老可能会破坏神经内分泌控制机制这一临床工作假设,我们在此检验一个特定的推论概念,即在健康的年轻男性而非老年男性中,睡眠阶段的转换、夜间阴茎勃起(NPT,一种由神经组织的信号)的波动以及促黄体生成素(LH)和/或睾酮的瞬时分泌速率是共同同步的。为此,我们通过密集的夜间多部位监测对10名年轻男性(年龄在21 - 31岁)和8名老年男性(年龄在65 - 74岁)进行了评估,即同时进行脑电图和NPT记录(每30秒一次)以及远程血液采样(每2.5分钟一次),以量化LH和睾酮的释放。对这些神经激素流出量度进行的与波形无关的反卷积和互相关分析表明,健康的年轻男性在夜间维持着四个显著的生理联系:1)睡眠阶段与NPT活动之间存在强烈的反向(确认性)关系,即深度睡眠伴随着NPT的抑制;2)NPT与睾酮分泌之间存在一致的耦合,其中NPT活动增强分别在睾酮分泌增加前12.5 - 32.5分钟和后50 - 60分钟出现;3)睡眠阶段与睾酮分泌之间存在明显的同步性,即睾酮分泌在睡眠加深的30分钟窗口(-2.5至25分钟)内增加;4)瞬时LH释放与NPT波动之间存在紧密的时间联系,即LH分泌在NPT下降前55 - 62.5分钟增加,在NPT下降后5 - 30分钟再次增加。相比之下,老年男性表现出预期的年轻成年同步性的全面丧失;即,1)睡眠阶段与NPT之间的反向关系消失,2)NPT波动与睾酮分泌去相关,3)睾酮释放与深度睡眠解耦,4)LH分泌与阴茎疲软之间的联系消失。总之,对年轻男性同时进行多种生殖神经内分泌流出量度的高强度夜间监测描绘了睡眠转换与NPT活动、LH和睾酮分泌或NPT波动以及睾酮分泌与深度睡眠阶段之间显著的神经生理耦合。相比之下,健康的老年男性表现出几乎普遍的年轻成年生理同步性破坏。因此,我们得出结论,男性生殖衰老的特征是睡眠转换、中枢神经系统驱动的NPT活动以及下丘脑驱动的阵发性促性腺激素释放激素/LH(从而睾丸间质细胞睾酮)分泌之间的协调调节受到侵蚀。在女性或非人类物种的生殖衰老过程中是否会出现类似的神经激素信号多重解耦尚不清楚。

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