Department of Pediatrics, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Horm Metab Res. 2013 Sep;45(9):669-74. doi: 10.1055/s-0033-1345141. Epub 2013 May 13.
We aimed to study uterine and ovarian morphology, hormonal levels, and pituitary height in prepubertal girls with pituitary hyperplasia secondary to primary hypothyroidism (PH) before and after thyroid hormone replacement therapy. We investigated 24 prepubertal girls with severe PH who were divided into 2 groups: secondary pituitary hyperplasia (group A, n=18), without pituitary hyperplasia (group B, n=6). Serum levels of free triiodothyronine (FT3), free thyroxine (FT4), thyrotropin (TSH), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T) and prolactin (PRL), pituitary height, uterine volume (UV), ovarian volume (OV), follicular diameter (FD), and follicular number (FN) in group A were measured before and 3-month after levothyroxine therapy. Age-matched healthy prepubertal girls (control group, n=30) were also enrolled in the study. The levels of FT3 and FT4 were significantly lower and the values of TSH, FSH, E2, PRL, pituitary height, UV, OV, and FD were significantly higher in group A than in the control group (all p<0.05). In group B, FT4 levels were significantly lower and TSH levels were significantly higher than in the control group (both p<0.05); the values of FSH, E2, PRL, UV, OV, and FD tended to be higher than those in the control group; there were no statistically significant differences (all p>0.05). After 3-month of therapy, hormonal levels regressed and imaging abnormalities decreased. Our results indicate that PH patients with pituitary hyperplasia have enlarged uterus, ovaries and follicles, as well as high values of FSH, E2, PRL, and pituitary height, which are improved after levothyroxine therapy.
我们旨在研究原发性甲状腺功能减退继发于垂体增生的青春期前女孩的子宫和卵巢形态、激素水平和垂体高度，以及在甲状腺激素替代治疗前后的变化。我们研究了 24 名患有严重 PH 的青春期前女孩，将其分为 2 组：继发垂体增生组（A 组，n=18）和无垂体增生组（B 组，n=6）。测量 A 组患者在左甲状腺素治疗前和治疗后 3 个月时游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、卵泡刺激素（FSH）、黄体生成素（LH）、雌二醇（E2）、睾酮（T）和催乳素（PRL）的血清水平、垂体高度、子宫体积（UV）、卵巢体积（OV）、卵泡直径（FD）和卵泡数量（FN）。还招募了年龄匹配的健康青春期前女孩（对照组，n=30）作为研究对象。与对照组相比，A 组的 FT3 和 FT4 水平显著降低，TSH、FSH、E2、PRL、垂体高度、UV、OV 和 FD 显著升高（均 P<0.05）。B 组 FT4 水平显著降低，TSH 水平显著高于对照组（均 P<0.05）；FSH、E2、PRL、UV、OV 和 FD 值均高于对照组，但差异无统计学意义（均 P>0.05）。治疗 3 个月后，激素水平恢复正常，影像学异常改善。我们的研究结果表明，继发于垂体增生的 PH 患者的子宫、卵巢和卵泡增大，FSH、E2、PRL 和垂体高度升高，经左甲状腺素治疗后得到改善。
