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急性和慢性雌激素对人体血清生长调节素活性、生长激素和催乳素的影响。

Acute and chronic estrogen effects upon serum somatomedin activity, growth hormone, and prolactin in man.

作者信息

Wiedemann E, Schwartz E, Frantz A G

出版信息

J Clin Endocrinol Metab. 1976 May;42(5):942-52. doi: 10.1210/jcem-42-5-942.

Abstract

Estrogen (E) reduces bioassayable GH-dependent serum somatomedin (SM) activity in acromegalics without affecting plasma growth hormone (GH) levels and inhibits the rise of SM activity normally produced by GH administration in GH-deficient subjects. We have now investigated the effect of E administration on serum SM activity and on plasma GH and prolactin (PRL) in 6 adult male subjects without pituitary pathology. Chronic E administration (ethinyl estradiol 0.5 mg/day for 7 to 70 days) reduced serum SM activity by 40 to 62% in each of 4 subjects (P less than 0.02 to less than 0.001). In 3 of the subjects, basal GH levels increased by 75 to 300% (P less than 0.05 to less than 0.001) and basal PRL levels increased by 90 to 200% (P less than 0.01 to less than 0.001). While iv administration of normal saline did not significantly affect either SM or GH, iv administration of E (bolus injection of 25 mg conjugated estrogens, USP) to 5 subjects resulted in: a) a 46 to 80% decrease in serum SM activity in all subjects, proceeding with an apparent half-life of 2 hours, becoming significant (P less than 0.05) at 2 hours (1 subject) to 3 hours (4 subjects), maximal at 6 hours, and persisting for 12 to 24 hours; b) GH elevation to 3 to 16 times baseline level (P less than 0.01) at 2 to 3 hours in 4 subjects; and c) no significant change of PRL levels in any subject. The mean GH response to iv E was maximal at a time (2 hours) when the mean SM activity had decreased only 20% and subsided well before the nadir of SM activity. The one patient without GH response to chronic or acute E administration may have been affected by absorption of triamcinolone being applied topically during the study. These results demonstrate that in males with normal pituitary function, E reduces serum SM activity, enhances basal GH and PRL secretion, and, upon iv injection, stimulates acute GH release. Although opposite chronic E effects upon GH and SM activity support a putative negative SM-GH feed-back mechanism, iv E administration apparently provokes acute GH release by a different mechanism. The half-life of serum SM activity in the human is probably much shorter than previously estimated.

摘要

雌激素(E)可降低肢端肥大症患者体内可通过生物测定法检测到的、依赖生长激素(GH)的血清生长调节素(SM)活性,而不影响血浆生长激素(GH)水平,并且能抑制给予GH的GH缺乏受试者中正常产生的SM活性升高。我们现已研究了给予E对6名无垂体病变的成年男性受试者血清SM活性、血浆GH和催乳素(PRL)的影响。长期给予E(乙炔雌二醇0.5毫克/天,持续7至70天)使4名受试者的血清SM活性分别降低了40%至62%(P小于0.02至小于0.001)。在3名受试者中,基础GH水平升高了75%至300%(P小于0.05至小于0.001),基础PRL水平升高了90%至200%(P小于0.01至小于0.001)。静脉注射生理盐水对SM或GH均无显著影响,而对5名受试者静脉注射E(大剂量注射25毫克结合雌激素,美国药典标准)导致:a)所有受试者的血清SM活性降低了46%至80%,其表观半衰期为2小时,在2小时(1名受试者)至3小时(4名受试者)时变得显著(P小于0.05),6小时时达到最大值,并持续12至24小时;b)4名受试者在2至3小时时GH升高至基线水平的3至16倍(P小于0.01);c)所有受试者的PRL水平均无显著变化。静脉注射E后,GH的平均反应在平均SM活性仅降低20%时达到最大值(2小时),且在SM活性最低点之前就已消退。在慢性或急性给予E时无GH反应的那名患者可能在研究期间受到了局部应用曲安西龙吸收的影响。这些结果表明,在垂体功能正常的男性中,E可降低血清SM活性,增强基础GH和PRL分泌,静脉注射时可刺激急性GH释放。尽管E对GH和SM活性的慢性影响相反,支持了一种假定的SM - GH负反馈机制,但静脉注射E显然通过不同机制引发急性GH释放。人体内血清SM活性的半衰期可能比先前估计的要短得多。

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