Brook C G, Hindmarsh P C
Department of Paediatric Endocrinology, Middlesex Hospital, London, England.
Endocrinol Metab Clin North Am. 1992 Dec;21(4):767-82.
Sex steroids markedly affect GH pulsatility by altering GH pulse amplitude without affecting GH pulse frequency. The type of sex steroid (testosterone or estrogen) appears to determine the timing of the pubertal growth spurt although both steroids appear to influence the amount of GH released from the pituitary. GH levels also affect gonadal secretion of sex steroids. The effects of the two are synergistic, but there is a real therapeutic dilemma of what to increase and when in children who are deficient in either GH or gonadotrophin secretion. Augmented GH pulsatility, particularly during the day, may alter markedly the interpretation of standard endocrine tests. Finally, the insulin resistance arising from an increased circulating concentration of GH may have important implications for the management of insulin-dependent diabetes during puberty.
性类固醇通过改变生长激素脉冲幅度而非影响生长激素脉冲频率，显著影响生长激素的脉冲性。性类固醇的类型（睾酮或雌激素）似乎决定了青春期生长突增的时间，尽管这两种类固醇似乎都会影响垂体释放的生长激素量。生长激素水平也会影响性腺分泌性类固醇。两者的作用是协同的，但对于生长激素或促性腺激素分泌不足的儿童，增加什么以及何时增加，确实存在治疗困境。生长激素脉冲性增强，尤其是在白天，可能会显著改变标准内分泌测试的结果。最后，生长激素循环浓度升高引起的胰岛素抵抗，可能对青春期胰岛素依赖型糖尿病的管理具有重要意义。
