Vermeulen A
J Clin Endocrinol Metab. 1976 Feb;42(2):247-53. doi: 10.1210/jcem-42-2-247.
The origin of plasma sex hormones in postmenopausal women was studied by determining plasma levels under basal conditions, after ACTH stimulation, and after dexamethasone suppression, as well as after hCG stimulation. Values obtained in postmenopausal women were compared with values observed during the follicular phase of the cycle in young women on the one hand, and with values in ovariectomized women of postmenopausal age on the other hand. All sex steroid levels studied with the exception of estrone, were significantly lower in postmenopausal women than in young women during the early follicular phase of the cycle. In ovariectomized women only androgen levels (testosterone, androstenedione, dihydrotestosterone, and to a lesser extent dehydroepiandrosterone,) were lower than in normal postmenopausal women, estrogen, 17 hydroxyprogesterone, and progesterone levels being similar. ACTH increased all plasma steroid levels except estradiol, whereas after dexamethasone, all sex hormone levels were significantly decreased. hCG stimulation finally caused an increase of borderline statistical significance in testosterone, dehydroepiandrosterone, and 17-hydroxyprogesterone levels. We have concluded from this study that the adrenal cortex is almost the exclusive source of plasma estradiol, estrone, progesterone, and 17OH progesterone and the most important source of plasma dehydroepiandrosterone; that the postmenopausal ovary appears to be responsible for about 50% of plasma testosterone and 30% of androstenedione levels; and that hCG stimulation with 5000 IU daily for 3 days, hardly influences steroid secretion by postmenopausal ovaries.
通过测定绝经后妇女在基础状态下、促肾上腺皮质激素(ACTH)刺激后、地塞米松抑制后以及人绒毛膜促性腺激素(hCG)刺激后的血浆水平,研究了绝经后妇女血浆性激素的来源。将绝经后妇女获得的值一方面与年轻女性月经周期卵泡期观察到的值进行比较,另一方面与绝经年龄的去卵巢妇女的值进行比较。除雌酮外,所研究的所有性类固醇水平在绝经后妇女中均显著低于月经周期早期卵泡期的年轻女性。在去卵巢妇女中,只有雄激素水平(睾酮、雄烯二酮、双氢睾酮,以及程度较轻的脱氢表雄酮)低于正常绝经后妇女,雌激素、17-羟孕酮和孕酮水平相似。ACTH增加了除雌二醇外的所有血浆类固醇水平,而在地塞米松作用后,所有性激素水平均显著下降。hCG刺激最终导致睾酮、脱氢表雄酮和17-羟孕酮水平出现临界统计学意义的升高。我们从这项研究中得出结论,肾上腺皮质几乎是血浆雌二醇、雌酮、孕酮和17-OH孕酮的唯一来源,也是血浆脱氢表雄酮的最重要来源;绝经后卵巢似乎负责约50%的血浆睾酮和30%的雄烯二酮水平;并且每天5000 IU连续3天的hCG刺激几乎不影响绝经后卵巢的类固醇分泌。