Fauser B C, Pache T D, Lamberts S W, Hop W C, de Jong F H, Dahl K D
Department of Obstetrics and Gynecology, Dijkzigt University Hospital, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 1991 Oct;73(4):811-7. doi: 10.1210/jcem-73-4-811.
Serum steroid, gonadotropin, and alpha-subunit levels were assessed in 35 women with cycle abnormalities [11 with and 24 without polycystic ovarian disease (PCOD) according to strict clinical and biochemical criteria] and 8 regularly cycling women in the early (cycle day 3 or 4) and mid (cycle day 7 or 8) follicular phase. LH and FSH levels were estimated using two immunological techniques [RIA and immunoradiometric assay (IRMA)] and in vitro bioassays (BIO), using mouse Leydig cells and rat granulosa cells, respectively. In PCOD patients mean alpha-subunit, free androgen index [FAI; testosterone x 100/sex hormone-binding globulin (SHBG)], androstenedione, estrone, and estradiol (E2) were significantly elevated compared to levels in the early follicular phase of control cycles and non-PCOD patients. In addition, in PCOD patients mean IRMA-LH and RIA-LH levels were distinctly increased (2.8- to 3.6 fold, respectively; both comparisons, P less than 0.001) compared to control values, but in the same order of magnitude (1.3- to 1.4-fold increments) as that in non-PCOD patients. However, the median BIO-LH level in PCOD patients was 5.9-fold higher than that in non-PCOD patients and 4.0-fold higher than the BIO-LH in the early follicular phase of control women. Consequently, the median BIO/IRMA-LH ratio was 4.8-fold higher in PCOD patients compared to non-PCOD patients. In women with cycle abnormalities, individual BIO/IRMA-LH ratios correlated with BIO-LH (rs = 0.48), FAI (rs = 0.39), free estrogens (E2/SHBG ratios; rs = 0 0.47), and dehydroepiandrosterone sulfate (rs = 0.60) concentrations. Mean IRMA-, RIA-, and BIO-FSH levels and BIO/IRMA-FSH ratios were not significantly different when various groups were compared. Although RIA- and IRMA-LH levels showed good correlation (rs = 0.88), RIA-LH levels were consistently higher, resulting in distinctly higher RIA-LH/FSH ratios (mean, 4.5) compared to IRMA-LH/FSH ratios (median, 1.8) in PCOD patients.(ABSTRACT TRUNCATED AT 400 WORDS)
对35名月经周期异常的女性[根据严格的临床和生化标准,其中11名患有多囊卵巢疾病(PCOD),24名未患]以及8名月经周期正常的女性在卵泡期早期(月经周期第3或4天)和中期(月经周期第7或8天)测定了血清类固醇、促性腺激素和α亚基水平。分别使用两种免疫技术[放射免疫分析法(RIA)和免疫放射测定法(IRMA)]以及体外生物测定法(BIO)来估计促黄体生成素(LH)和促卵泡生成素(FSH)水平,体外生物测定法分别使用小鼠睾丸间质细胞和大鼠颗粒细胞。与对照周期的卵泡期早期以及非PCOD患者相比,PCOD患者的平均α亚基、游离雄激素指数[FAI;睾酮×100/性激素结合球蛋白(SHBG)]、雄烯二酮、雌酮和雌二醇(E2)显著升高。此外,与对照值相比,PCOD患者的平均IRMA-LH和RIA-LH水平明显升高(分别为2.8至3.6倍;两组比较,P均小于0.001),但与非PCOD患者处于相同数量级(增加1.3至1.4倍)。然而,PCOD患者的BIO-LH水平中位数比非PCOD患者高5.9倍,比对照女性卵泡期早期的BIO-LH高4.0倍。因此,PCOD患者的BIO/IRMA-LH比值中位数比非PCOD患者高4.8倍。在月经周期异常的女性中,个体BIO/IRMA-LH比值与BIO-LH(rs = 0.48)、FAI(rs = 0.39)、游离雌激素(E2/SHBG比值;rs = 0.47)和硫酸脱氢表雄酮(rs = 0.60)浓度相关。比较不同组时,平均IRMA-、RIA-和BIO-FSH水平以及BIO/IRMA-FSH比值无显著差异。尽管RIA-LH和IRMA-LH水平显示出良好的相关性(rs = 0.88),但RIA-LH水平始终较高,导致PCOD患者的RIA-LH/FSH比值(平均为4.5)明显高于IRMA-LH/FSH比值(中位数为1.8)。(摘要截断于400字)