Trakakis E, Chryssikopoulos A, Sarandakou A, Phocas I, Rizos D, Gregoriou O, Kontoravdis A, Creatsas G
Second Department of Obstetrics and Gynecology, University of Athens, Greece.
Int J Fertil Womens Med. 2001 Jan-Feb;46(1):37-41.
The purpose of this study was to evaluate thyroid function and TSH and cortisol (F) secretion in hyperandrogenemic women with nonclassical congenital adrenal hyperplasia (NC-CAH) due to 21-hydroxylase deficiency (Group A) when compared with women with hyperandrogenemic symptoms (menstrual irregularities, hirsutism, acne, seborrhea and sterility) of other etiologies (Group B).
Seventy-two women were subjected to stimulation of the adrenal cortex with i.v. ACTH administration in the early proliferative phase of the menstrual cycle. Basal plasma TSH, T3, T4, and FTI as well as basal and ACTH-stimulated plasma F and 17-hydroxyprogesterone levels were determined.
According to internationally accepted criteria and HLA haplotyping, we diagnosed 28 NC-CAH patients as well as affected heterozygotes of the disease. No significant difference was found in the plasma T3, T4, or FTI or F concentrations between the women of the two groups. On the contrary, plasma TSH levels were significantly lower in patients with 21-hydroxylase deficiency when compared to the women with hyperandrogenemic symptoms of other etiologies.
The results of this study support a dysfunction of the hypothalamic-pituitary-thyroidal axis due to altered ACTH secretion patterns.
本研究旨在评估因21-羟化酶缺乏导致非经典型先天性肾上腺皮质增生（NC-CAH）的高雄激素血症女性（A组）与其他病因导致高雄激素血症症状（月经不规律、多毛、痤疮、脂溢性皮炎和不育）的女性（B组）的甲状腺功能、促甲状腺激素（TSH）和皮质醇（F）分泌情况。
72名女性在月经周期的增殖早期接受静脉注射促肾上腺皮质激素（ACTH）刺激肾上腺皮质。测定基础血浆TSH、T3、T4和游离甲状腺素指数（FTI）以及基础和ACTH刺激后的血浆F和17-羟孕酮水平。
根据国际公认标准和人类白细胞抗原（HLA）单倍型分析，我们诊断出28例NC-CAH患者以及该疾病的受累杂合子。两组女性的血浆T3、T4、FTI或F浓度均未发现显著差异。相反，与其他病因导致高雄激素血症症状的女性相比，21-羟化酶缺乏患者的血浆TSH水平显著降低。
本研究结果支持由于ACTH分泌模式改变导致下丘脑-垂体-甲状腺轴功能障碍。
