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男孩青春发育期后期促黄体生成素和睾酮分泌更有序的发育限定性出现。

Developmentally delimited emergence of more orderly luteinizing hormone and testosterone secretion during late prepuberty in boys.

作者信息

Veldhuis J D, Pincus S M, Mitamura R, Yano K, Suzuki N, Ito Y, Makita Y, Okuno A

机构信息

Division of Endocrinology, Department of Internal Medicine, General Clinical Research Center, University of Virginia School of Medicine, Charlottesville, Virginia 22908-0202, USA.

出版信息

J Clin Endocrinol Metab. 2001 Jan;86(1):80-9. doi: 10.1210/jcem.86.1.7127.

Abstract

To quantitate changing feedback control in the GnRH-LH/FSH-testosterone axis in male puberty, we here quantitate the orderliness of hormone release patterns using the regularity (pattern-sensitive) statistic, approximate entropy (ApEn), in 46 eugonadal boys representing 6 genitally defined stages of normal puberty. ApEn is a single variable, model-free, and scale-independent barometer of coordinate signaling or integrative regulation within a coupled neuroendocrine axis. Accordingly, we quantitated ApEn of LH profiles obtained by immunofluorometric assay of sera sampled every 20 min for 24 h. LH ApEn declined remarkably between early prepuberty (genital stage I-A: mean bone age, 4.6 +/- 1.6 yr; testis volume, <3 mL for at least 3 succeeding yr) and late prepuberty (genital stage I-C: bone age, 8.7 +/- 1.8 yr; testis volume, <3 mL for up to 1 yr thereafter; P: = 0.00019), which indicates the acquisition of more regular LH release patterns in late prepuberty. Maximal LH orderliness occurred in puberty stage II (bone age, 10.7 +/- 1.0 yr; testis volume, 2.8 +/- 0.4 mL). The LH secretory process was more disorderly in mid- and later puberty (Tanner stages III and IV). Transpubertal variations in testosterone ApEn manifested a similar tempo, i.e. the greatest regularity of testosterone secretion (lowest ApEn) emerged in Tanner genital stage II (P: < 10(-)(7)), with less orderly patterns evident both earlier and later in sexual development. In contrast, FSH ApEn values remained invariant of pubertal status. Analysis of bihormonal coupling using the theoretically related bivariate cross-ApEn statistic disclosed maximal 2-hormone synchrony for LH and testosterone secretion in genital stage II (P: = 0.031), with relative deterioration of coordinate LH and testosterone release patterns both before and after. LH and FSH release became maximally synchronous at the end of prepuberty (genital stage I-C; P: = 0.029), and FSH and testosterone synchrony peaked in pubertal stage III (P: = 0.037). As mean 24-h serum concentrations of LH, FSH, and testosterone rose transpubertally by 35-fold (LH), 68-fold (FSH), and 70-fold (testosterone), respectively, we infer that pubertal developmental stage per se rather than level of hormone output dictates coordinate GnRH-LH/FSH-testosterone secretion. In summary, in eugonadal boys, the regularity of 24-h LH and testosterone secretory patterns undergoes well defined pubertal stage-specific control. No sexually developmentally delimited regulation is inferable for FSH. The concept of temporally biphasic puberty-dependent variations in neurohormone secretory regularity contrasts with the unidirectional rise in daily hormone output. Accordingly, we infer that late prepuberty and early puberty (Tanner genital stages IC and II) embody a physiologically unique sexual developmental window, marked by transiently enhanced LH and testosterone feedback stability in boys. Whether analogous plasticity of hypothalamo-pituitary-gonadal interactions unfolds during female adolescence is not known.

摘要

为了量化男性青春期促性腺激素释放激素-促黄体生成素/促卵泡生成素-睾酮轴中不断变化的反馈控制,我们在此使用规律性(模式敏感)统计量近似熵(ApEn),对46名性腺功能正常的男孩进行激素释放模式的有序性量化,这些男孩代表了正常青春期6个生殖器定义阶段。ApEn是一个单一变量、无模型且与尺度无关的指标,用于衡量耦合神经内分泌轴内的协调信号或整合调节。因此,我们对通过免疫荧光测定法每20分钟采集一次血清,共采集24小时所获得的促黄体生成素(LH)曲线的ApEn进行了量化。LH的ApEn在青春期前早期(生殖器I - A期:平均骨龄4.6±1.6岁;睾丸体积,至少连续3年<3 mL)和青春期前后期(生殖器I - C期:骨龄8.7±1.8岁;睾丸体积,此后1年内<3 mL;P = 0.00019)之间显著下降,这表明青春期前后期LH释放模式变得更加规律。LH的最大有序性出现在青春期II期(骨龄10.7±1.0岁;睾丸体积2.8±0.4 mL)。在青春期中期和后期(坦纳III期和IV期),LH分泌过程更加紊乱。睾酮的ApEn在青春期的变化表现出类似的节奏,即睾酮分泌的最大规律性(最低ApEn)出现在坦纳生殖器II期(P < 10⁻⁷),在性发育的早期和后期模式都不太有序。相比之下,促卵泡生成素(FSH)的ApEn值不受青春期状态的影响。使用理论上相关的双变量交叉ApEn统计量对双激素耦合进行分析发现,在生殖器II期,LH和睾酮分泌的2激素同步性最大(P = 0.031),在此之前和之后,LH和睾酮的协调释放模式相对变差。在青春期前结束时(生殖器I - C期),LH和FSH释放达到最大同步性(P = 0.029),FSH和睾酮的同步性在青春期III期达到峰值(P = 0.037)。由于青春期期间LH、FSH和睾酮的24小时血清平均浓度分别升高了35倍(LH)、68倍(FSH)和70倍(睾酮),我们推断青春期发育阶段本身而非激素输出水平决定了促性腺激素释放激素-促黄体生成素/促卵泡生成素-睾酮的协调分泌。总之,在性腺功能正常的男孩中,24小时LH和睾酮分泌模式的规律性受到明确的青春期阶段特异性控制。无法推断出FSH存在性发育界定的调节。神经激素分泌规律性在时间上呈双相的青春期依赖性变化这一概念与每日激素输出的单向增加形成对比。因此,我们推断青春期前后期和青春期早期(坦纳生殖器IC期和II期)体现了一个生理上独特的性发育窗口,其特征是男孩中LH和睾酮反馈稳定性的短暂增强。女性青春期期间下丘脑-垂体-性腺相互作用是否存在类似的可塑性尚不清楚。

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