Sherman B M, Halmi K A, Zamudio R
J Clin Endocrinol Metab. 1975 Jul;41(1):135-42. doi: 10.1210/jcem-41-1-135.
The LH and FSH responses to the administration of synthetic gonadotropin-releasing hormone (GnRH) were assessed in 14 patients with anorexia nervosa before, during and following weight gain. In 8 patients studied prior to therapy when they were at 53-64% of idal body weight, the LH response to GnRH was strikingly impaired while the FSH response was equal to that observed in normally menstruating women. After return to 79-88% of ideal body weight the LH response was improved but remained less than in the normal women. In a second group of 6 patients who were studied 4-11 months after hospital discharge when they were 90-94% of ideal body weight, the LH response was always equal to or greater than that found in the normal women. The serum estradiol concentration was low in all of the patients and remained less than 33 pg/ml even in those who returned to more than 90% of ideal body weight. Treatment with 25 mug of ethinyl estradiol for 3 days prior to repeat administration of GnRH did not result in a statistically significant increase of the LH or FSH responses above those before treatment. These data suggest changes occur in both hypothalamic and pituitary regulation of gonadotropin secretion in the course of nutritional rehabilitation of patients with anorexia nervosa and that synthesis and secretion of LH and FSH are modulated independently at the level of the pituitary gland.
在14例神经性厌食症患者体重增加前、体重增加期间及体重增加后，评估了促黄体生成素（LH）和促卵泡生成素（FSH）对合成促性腺激素释放激素（GnRH）给药的反应。在8例治疗前体重为理想体重53%-64%的患者中，LH对GnRH的反应显著受损，而FSH反应与正常月经女性观察到的反应相当。恢复到理想体重的79%-88%后，LH反应有所改善，但仍低于正常女性。在第二组6例患者中，在出院后4-11个月进行研究，当时他们的体重为理想体重的90%-94%，LH反应始终等于或大于正常女性。所有患者的血清雌二醇浓度均较低，即使在体重恢复到理想体重90%以上的患者中，血清雌二醇浓度仍低于33 pg/ml。在重复给予GnRH前3天用25 μg炔雌醇治疗，未导致LH或FSH反应在统计学上显著高于治疗前。这些数据表明，在神经性厌食症患者营养康复过程中，下丘脑和垂体对促性腺激素分泌的调节均发生变化，且LH和FSH的合成与分泌在垂体水平受到独立调节。
