Rossmanith W G, Liu C H, Laughlin G A, Mortola J F, Suh B Y, Yen S S
Department of Obstetrics-Gynecology, University of Ulm, FR Germany.
Clin Endocrinol (Oxf). 1990 May;32(5):647-60. doi: 10.1111/j.1365-2265.1990.tb00909.x.
The basic premise of this study is that the GnRH-LH pulsatile activity, particularly its frequency characteristics, constitutes, in the absence of any considerable ovarian feedback, the intrinsic rhythm of the hypothalamic-pituitary unit at its maximal rate. Thus, LH pulse attributes determined in postpubertal hypogonadal subjects may be used as a reference in assessing the degree of influence exerted by endocrine factors that modulate GnRH-LH pulses. Accordingly, serum LH levels were determined in samples obtained at 15-min intervals for 24 h in 20 hypogonadal women: 13 postmenopausal women (PMW) and seven women with premature ovarian failure (POF). Similar measurements were performed in 60 normally cycling women: 25 in the early follicular phase (EFP), 13 in the late follicular phase (LFP), seven at midcycle surge (LH surge) and 15 in the midluteal phase (MLP). Significant pulses were identified by the cluster algorithm utilizing factors appropriate for 24 h data series of a sampling frequency of 15-min intervals. The results show a 24-h mean (+/- SE) LH pulse frequency of 78.2 +/- 2.8 and 85.5 +/- 2.4 min per pulse for young (POF) and older (PMW) hypogonadal women, respectively. During the follicular phase of the cycle, the LH pulse frequency is not significantly different from that of hypogonadal women, but there is a significant (P less than 0.05) increase from early to late follicular phases (95.4 +/- 3.3 vs 78.8 +/- 2.2 min per pulse). However, when the sleep periods are excluded from the 24-h data series because of the associated decrease of LH pulse frequency in EFP women, the resulting pulse frequencies are almost identical for EFP, LFP and PMW. An elevation beyond the basic pulse rhythm determined in PMW or POF is not observed in any phase of the menstrual cycle studied, including the midcycle surge. The decrease in LH pulse frequency during the luteal phase of the cycle (151.8 +/- 8.0 min per pulse, P less than 0.001 vs hypogonadal women) beyond the reference pulse frequency of hypogonadal women is unequivocal. By contrast, the pulse amplitude varies markedly among the groups with the largest found in POF (36.6 +/- 4.5 IU/l). It follows, in descending order, PMW (22.7 +/- 3.1 IU/l), midcycle surge (17.3 +/- 2.8 IU/l), MLP women (7.0 +/- 1.3 IU/l) and the EFP (4.9 +/- 0.3 IU/l) and LFP (4.0 +/- 0.4 IU/l).(ABSTRACT TRUNCATED AT 250 WORDS)
本研究的基本前提是，在没有任何显著卵巢反馈的情况下，促性腺激素释放激素（GnRH）-促黄体生成素（LH）的脉冲活动，尤其是其频率特征，构成了下丘脑-垂体单位以最大速率运行的内在节律。因此，在青春期后性腺功能减退的受试者中测定的LH脉冲特征，可作为评估调节GnRH-LH脉冲的内分泌因素所施加影响程度的参考。据此，对20名性腺功能减退的女性进行了如下研究：每15分钟采集一次血样，共采集24小时，测定血清LH水平，其中包括13名绝经后女性（PMW）和7名卵巢早衰（POF）女性。对60名月经周期正常的女性进行了类似测量：25名处于卵泡早期（EFP），13名处于卵泡晚期（LFP），7名处于月经周期中期LH峰时，15名处于黄体中期（MLP）。利用适用于采样频率为15分钟间隔的24小时数据系列的聚类算法识别显著脉冲。结果显示，年轻（POF）和年长（PMW）性腺功能减退女性的24小时平均（±标准误）LH脉冲频率分别为每脉冲78.2±2.8分钟和85.5±2.4分钟。在月经周期的卵泡期，LH脉冲频率与性腺功能减退女性的频率无显著差异，但从卵泡早期到晚期有显著（P<0.05）增加（分别为每脉冲95.4±3.3分钟和78.8±2.2分钟）。然而，由于EFP女性在睡眠期间LH脉冲频率会下降，将睡眠期从24小时数据系列中排除后，EFP、LFP和PMW的所得脉冲频率几乎相同。在所研究的月经周期的任何阶段，包括月经周期中期LH峰，均未观察到LH脉冲频率超过在PMW或POF中确定的基本脉冲节律。月经周期黄体期LH脉冲频率（每脉冲151.8±8.0分钟，与性腺功能减退女性相比P<0.001）超过性腺功能减退女性的参考脉冲频率，这一点是明确的。相比之下，脉冲幅度在各组之间有显著差异，最大的是POF组（36.6±4.5 IU/l）。其次是PMW组（22.7±3.1 IU/l）、月经周期中期LH峰组（17.3±2.8 IU/l）、MLP组女性（7.0±1.3 IU/l）以及EFP组（4.9±0.3 IU/l）和LFP组（4.0±0.4 IU/l）。（摘要截断于250字）
