Hansen K K, Knopp R H, Soules M R
Department of Obstetrics and Gynecology, University of Washington, Seattle 98195.
Fertil Steril. 1991 May;55(5):916-21.
To determine if reductions in plasma progesterone (P) secretion seen in luteal phase deficiency (LPD) might be because of reduced availability of circulating low-density lipoprotein (LDL) or high-density lipoprotein (HDL), known substrates for corpus luteum P synthesis.
We measured plasma lipoproteins in the luteal phase of the menstrual cycle in 39 infertile women. These women were divided into two groups on the basis of endometrial biopsies; the LPD group had biopsies that were greater than or equal to 3 days out-of-phase.
All participants were recruited from the Reproductive Endocrinology and Infertility Clinic at the University of Washington, an institutional tertiary care center.
PATIENTS, PARTICIPANTS: Eighteen women had in-phase and 21 had out-of-phase LPD biopsies.
Lipoprotein levels were obtained in a fasted state on the day of the luteal phase on which the biopsy was performed.
No difference in covariates that affect lipoprotein levels such as obesity, age, and alcohol use were observed between the two groups. No significant differences between groups were found for triglycerides, total cholesterol, very low density lipoprotein, LDL, HDL, HDL2, and HDL3 concentrations. However, LPD was associated with a reduction in the extent to which: age and obesity are associated with higher triglycerides; obesity is associated with a lower HDL2; and alcohol is associated with a higher HDL3-cholesterol.
Lipoproteins on average are not different in LPD, suggesting reasons other than a deficient plasma lipoprotein cholesterol source as the explanation for decreased P secretion. A lesser interaction between LDL or HDL and obesity, age, and alcohol in LPD could signify an influence of the altered hormonal milieu of LPD on the way lipoproteins interact with covariates and could lead to differences in lipoproteins between normal and LPD subjects at the extremes of the lipoprotein distribution.
确定黄体期缺陷（LPD）中所见的血浆孕酮（P）分泌减少是否可能是由于循环低密度脂蛋白（LDL）或高密度脂蛋白（HDL）的可用性降低，已知它们是黄体P合成的底物。
我们测量了39名不孕妇女月经周期黄体期的血浆脂蛋白。这些妇女根据子宫内膜活检分为两组；LPD组的活检结果显示相差大于或等于3天。
所有参与者均从华盛顿大学生殖内分泌与不孕诊所招募，该诊所是一家机构三级护理中心。
患者、参与者：18名妇女的活检结果为同期，21名妇女的活检结果为不同期的LPD。
在进行活检的黄体期当天，在空腹状态下获取脂蛋白水平。
两组之间在影响脂蛋白水平的协变量（如肥胖、年龄和饮酒）方面未观察到差异。两组之间在甘油三酯、总胆固醇、极低密度脂蛋白、LDL、HDL、HDL2和HDL3浓度方面未发现显著差异。然而，LPD与以下方面的关联程度降低有关：年龄和肥胖与较高甘油三酯的关联；肥胖与较低HDL2的关联；以及饮酒与较高HDL3胆固醇的关联。
LPD患者的脂蛋白平均水平无差异，这表明除血浆脂蛋白胆固醇来源不足外，还有其他原因可解释P分泌减少。LPD中LDL或HDL与肥胖、年龄和饮酒之间的相互作用较小，这可能意味着LPD激素环境改变对脂蛋白与协变量相互作用方式的影响，并可能导致脂蛋白分布两端的正常受试者和LPD受试者之间的脂蛋白差异。
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