Samborski Włodzimierz, Sobieska Magdalena, Pieta Przemysław, Drews Krzysztof, Brzosko Marek
Clinic for Physiotherapy, Rheumatology and Rehabilitation, University of Medical Sciences, Poznań, Poland.
Ann Acad Med Stetin. 2005;51(2):23-6.
One of the prevailing hypotheses on the pathogenesis of fibromyalgia (FM) emphasizes the role of the hypothalamic-pituitary-gonadal axis in this condition. Aberrant function of the axis was inferred from decreased concentrations of growth hormone and serotonin and reduced urinary excretion of corticosteroid metabolites observed in FM patients. Studies in a very limited number of FM patients suggest that disturbances in the hypothalamic-pituitary-gonadal axis may also lead to changes in the synthesis of sex hormones.
This study was performed in 19 women aged 23 to 46 years in whom FM was diagnosed according to ACR criteria. The control group consisted of 18 healthy women aged 21 to 41 years. Pain intensity and sleep quality was assessed with the Visual Analogue Scale (VAS). The number of points reported as painful ("tender points") was measured by dolorimetry. Hormones or contraceptives were not administered to the women during the pre-study period. Blood was collected on day 8 or 9 of the menstrual cycle and serum was prepared for measurements of estradiol and progesterone with Microparticle Enzyme Immunoassay (MEIA) and AxSYM reagents from Abbott (USA).
The study and control groups differed as to pain intensity and sleep quality, as well as number of tender points reported. However, groups did not differ as to mean concentration of estradiol or progesterone.
A deficit of sex hormones does not appear to be part of the manifestations of FM.
关于纤维肌痛（FM）发病机制的一个主流假说是强调下丘脑 - 垂体 - 性腺轴在这种疾病中的作用。从FM患者中观察到的生长激素和血清素浓度降低以及皮质类固醇代谢产物尿排泄减少推断出该轴的功能异常。对极少数FM患者的研究表明，下丘脑 - 垂体 - 性腺轴的紊乱也可能导致性激素合成的变化。
本研究对19名年龄在23至46岁之间、根据美国风湿病学会（ACR）标准诊断为FM的女性进行。对照组由18名年龄在21至41岁之间的健康女性组成。使用视觉模拟量表（VAS）评估疼痛强度和睡眠质量。通过痛觉测量法测量报告为疼痛的点数（“压痛点”）。在研究前期间未对这些女性施用激素或避孕药。在月经周期的第8天或第9天采集血液，并使用来自美国雅培公司的微粒酶免疫测定（MEIA）和AxSYM试剂制备血清以测量雌二醇和孕酮。
研究组和对照组在疼痛强度、睡眠质量以及报告的压痛点数量方面存在差异。然而，两组在雌二醇或孕酮的平均浓度方面没有差异。
性激素缺乏似乎不是FM表现的一部分。
