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特纳综合征青春期前女孩低剂量雌激素治疗后生长激素分泌率增加。

Increased hGH production rate after low-dose estrogen therapy in prepubertal girls with Turner's syndrome.

作者信息

Mauras N, Rogol A D, Veldhuis J D

机构信息

Nemours Children's Clinic, Jacksonville, Florida 32247.

出版信息

Pediatr Res. 1990 Dec;28(6):626-30. doi: 10.1203/00006450-199012000-00018.

Abstract

Low-dose estrogen therapy significantly increases radioimmunoassayable serum hGH concentrations in the prepubertal hypogonadal female. In this study, we have examined the effects of short- and long-term low-dose ethinyl estradiol therapy on the endogenous production rates and metabolic clearance rates of hGH. We used deconvolution mathematical modeling to provide quantitative estimates of individual secretory parameters and to calculate subject-specific hGH metabolic clearance rates, by using all serum hGH concentrations and their variances considered simultaneously. Nine girls with Turner's syndrome (mean age 7.7 +/- 0.5 y) were studied on three separate nights by drawing blood every 20 min from 2200 to 0800 h before (I), after 1 wk (II), and 5 wk (III) of 100 ng/kg/d ethinyl estradiol therapy orally. We found that the endogenous hGH production rate more than doubled in all patients studied after 5 wk of ethinyl estradiol therapy (194 +/- 22 (I), 290 +/- 43 (II), and 412 +/- 66 (III) micrograms/L/12 h; p less than 0.05 for I and III). The half-life of endogenous hGH was not altered in the estrogen treatment paradigm with a mean of 19 +/- 1.6 min in study I and 18 +/- 1.2 min in both studies II and III. Our results suggest that even prepubertal concentrations of gonadal steroids in the hypogonadal female may be physiologically relevant to the maintenance of normal somatotrope secretory function.

摘要

低剂量雌激素疗法可显著提高青春期前性腺功能减退女性血清中可通过放射免疫法检测到的人生长激素(hGH)浓度。在本研究中,我们检测了短期和长期低剂量乙炔雌二醇疗法对hGH内源性生成率和代谢清除率的影响。我们使用反卷积数学模型,通过同时考虑所有血清hGH浓度及其方差,对个体分泌参数进行定量估计,并计算个体特异性的hGH代谢清除率。对9名特纳综合征女孩(平均年龄7.7±0.5岁)进行了研究,在三个不同的夜晚,于口服100 ng/kg/d乙炔雌二醇治疗前(I)、治疗1周后(II)和5周后(III),从22:00至08:00每20分钟采集一次血液。我们发现,在所有接受研究的患者中,乙炔雌二醇治疗5周后,内源性hGH生成率增加了一倍多(I期为194±22、II期为290±43、III期为412±66微克/升/12小时;I期和III期相比,p<0.05)。在内源性hGH的半衰期在雌激素治疗模式下未发生改变,研究I期的平均半衰期为19±1.6分钟,研究II期和III期均为18±1.2分钟。我们的结果表明,即使是性腺功能减退女性青春期前的性腺类固醇浓度,在生理上也可能与维持正常的生长激素分泌功能相关。

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