肥胖症中下丘脑-垂体-肾上腺轴与性激素之间关系的性别差异。

Sex difference in the relationship between the hypothalamic-pituitary-adrenal axis and sex hormones in obesity.

作者信息

Vicennati Valentina, Ceroni Luana, Genghini Silvia, Patton Laura, Pagotto Uberto, Pasquali Renato

机构信息

Division of Endocrinology, S. Orsola-Malpighi Hospital, University Alma Mater Studiorum, Bologna, Italy.

出版信息

Obesity (Silver Spring). 2006 Feb;14(2):235-43. doi: 10.1038/oby.2006.30.

DOI:10.1038/oby.2006.30

PMID:16571848

Abstract

OBJECTIVE

This study was carried out to investigate the role of sex in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis and its relationship with testosterone levels in male and female obesity.

RESEARCH METHODS AND PROCEDURES

Twenty-two obese men (OB-M) and 29 obese women (OB-W) participated in the study. Two groups of normal weight men (NW-M) and women (NW-W), respectively, served as controls. In basal conditions, blood concentrations of major androgens, sex hormone-binding protein, and gonadotropins were assessed, and the free androgen index (testosterone x100/sex hormone-binding globulin) was calculated. All subjects underwent a combined corticotropin-releasing hormone plus arginine-vasopressin stimulation test.

RESULTS

OB-M and NW-M had higher basal adrenal cortical tropic hormone (ACTH) and cortisol levels than their female counterparts. In addition, ACTH, but not cortisol basal, levels were significantly higher in obese than in normal weight controls in both sexes. OB-W had a higher response than OB-M to the combined corticotropin-releasing hormone plus arginine-vasopressin test of both ACTH and cortisol [expressed as incremental percentage of area under the curve (AUC%)]. The same finding was present between NW-W and NW-M. Basal luteinizing hormone levels were negatively correlated to ACTH(AUC%) in both OB-W and OB-M. In the OB-W, however, a positive correlation was found between cortisol(AUC%) and testosterone (r = 0.48; p = 0.002), whereas a tendency toward a negative correlation was present in OB-M.

DISCUSSION

In conclusion, we have shown a significant positive relationship between the activity of the HPA axis and testosterone in obese women, which suggests a partial responsibility of increased HPA axis activity in determining testosterone levels. In addition, it clearly seems that, as reported in normal weight subjects, a sex difference in the HPA axis activity still persists even in the presence of obesity.

摘要

目的

本研究旨在探讨性别在调节下丘脑 - 垂体 - 肾上腺（HPA）轴中的作用及其与男性和女性肥胖患者睾酮水平的关系。

研究方法与步骤

22名肥胖男性（OB - M）和29名肥胖女性（OB - W）参与了本研究。两组正常体重男性（NW - M）和女性（NW - W）分别作为对照。在基础状态下，评估主要雄激素、性激素结合蛋白和促性腺激素的血浓度，并计算游离雄激素指数（睾酮×100/性激素结合球蛋白）。所有受试者均接受促肾上腺皮质激素释放激素加精氨酸加压素联合刺激试验。

结果

OB - M和NW - M的基础肾上腺皮质促激素（ACTH）和皮质醇水平高于女性对应者。此外，无论男女，肥胖者的ACTH基础水平显著高于正常体重对照组，但皮质醇基础水平无显著差异。OB - W对促肾上腺皮质激素释放激素加精氨酸加压素联合试验的ACTH和皮质醇反应（以曲线下面积增加百分比表示，AUC%）高于OB - M。NW - W和NW - M之间也有相同的发现。OB - W和OB - M的基础黄体生成素水平与ACTH（AUC%）均呈负相关。然而，在OB - W中，皮质醇（AUC%）与睾酮呈正相关（r = 0.48；p = 0.002），而在OB - M中呈负相关趋势。