Brochu M, Bélanger A
Laboratory of Molecular Endocrinology, Le Centre Hospitalier de l'Université Laval, Québec, Canada.
Prostate. 1987;11(1):33-40. doi: 10.1002/pros.2990110105.
Plasma steroids were analyzed in 16 normal men and in 10 men with prostatic benign hyperplasia (BPH). The steroids measured by radioimmunoassay include pregnenolone, 17-OH-pregnenolone, dehydroepiandrosterone, androst-5-ene-3 beta, 17 beta-diol, testosterone, dihydrotestosterone, androstane-3 alpha, 17 beta-diol, androstane-3 beta, 17 beta-diol, estrone, and estradiol as well as their glucuronide derivatives. In addition, cortisol and the sulphoconjugated form of dehydroepiandrosterone were determined. Whereas the levels of pregnenolone, pregnenolone glucuronide and 17-OH-pregnenolone glucuronide are not different in the two groups, the levels of 17-OH-pregnenolone in the BPH group (0.87 +/- 0.07 ng/ml) exceed by two-fold (p less than 0.01) those observed in normal men. Plasma dehydroepiandrosterone and androst-5-ene-3 beta, 17 beta-diol concentrations are markedly elevated in the BPH group (1.49 +/- 0.23 and 0.55 +/- 0.08 ng/ml vs the control groups 0.43 +/- 0.11 and 0.31 +/- 0.05 ng/ml, respectively). Since the plasma cortisol and pregnenolone levels are comparable in these two groups, our data suggest that the elevation of plasma 17-OH-pregnenolone, dehydroepiandrosterone, and androst-5-ene-3 beta, 17 beta-diol reflects an increase of adrenal 17-hydroxylase activity in patients with BPH. A slight increase of the plasma dihydrotestosterone and androsterone glucuronide concentration is also observed in men with BPH, indicating an increase of 5 alpha-reduced androgen formation. We have also observed, in the BPH group, a 50% decrease (p less than 0.01) of plasma glucuronidated androst-5-ene-3 beta, 17 beta-diol, estrone, and estradiol levels, suggesting that the transformation of unconjugated estrogenic steroids into glucuronide derivative is inhibited in BPH patients. In summary, our data indicate that adrenal C-19 steroids might be involved in the process of BPH. Furthermore, whereas the estrogen glucuronide formation is diminished in men with BPH, the prostatic androgen metabolism as reflected by plasma dihydrotestosterone and androsterone glucuronide concentrations seems to be increased.
对16名正常男性和10名前列腺良性增生（BPH）男性的血浆类固醇进行了分析。通过放射免疫分析测定的类固醇包括孕烯醇酮、17-羟基孕烯醇酮、脱氢表雄酮、雄甾-5-烯-3β,17β-二醇、睾酮、双氢睾酮、雄烷-3α,17β-二醇、雄烷-3β,17β-二醇、雌酮和雌二醇及其葡萄糖醛酸衍生物。此外，还测定了皮质醇和脱氢表雄酮的硫酸结合形式。虽然两组中孕烯醇酮、孕烯醇酮葡萄糖醛酸和17-羟基孕烯醇酮葡萄糖醛酸的水平没有差异，但BPH组中17-羟基孕烯醇酮的水平（0.87±0.07 ng/ml）比正常男性中观察到的水平高出两倍（p<0.01）。BPH组中血浆脱氢表雄酮和雄甾-5-烯-3β,17β-二醇的浓度显著升高（分别为1.49±0.23和0.55±0.08 ng/ml，而对照组分别为0.43±0.11和0.31±0.05 ng/ml）。由于这两组中血浆皮质醇和孕烯醇酮水平相当，我们的数据表明，BPH患者血浆中17-羟基孕烯醇酮、脱氢表雄酮和雄甾-5-烯-3β,17β-二醇的升高反映了肾上腺17-羟化酶活性的增加。在BPH男性中还观察到血浆双氢睾酮和雄酮葡萄糖醛酸浓度略有增加，表明5α-还原雄激素生成增加。我们还观察到，在BPH组中，血浆葡萄糖醛酸化的雄甾-5-烯-3β,17β-二醇、雌酮和雌二醇水平降低了50%（p<0.01），这表明BPH患者中未结合的雌激素类固醇向葡萄糖醛酸衍生物的转化受到抑制。总之，我们的数据表明肾上腺C-19类固醇可能参与了BPH的过程。此外，虽然BPH男性中雌激素葡萄糖醛酸的形成减少，但血浆双氢睾酮和雄酮葡萄糖醛酸浓度所反映的前列腺雄激素代谢似乎增加了。
