Loucks A B, Mortola J F, Girton L, Yen S S
Department of Reproductive Medicine, School of Medicine (T-002), University of California-San Diego, La Jolla 92093.
J Clin Endocrinol Metab. 1989 Feb;68(2):402-11. doi: 10.1210/jcem-68-2-402.
The functional integrity of the hypothalamic-pituitary-ovarian and hypothalamic-pituitary-adrenal axes was assessed by determining pulsatile LH, ACTH, and cortisol secretion during the early follicular phase in athletic women with regular menstrual cycles (CA; n = 9), athletic women with amenorrhea (AA; n = 9), and regularly cyclic sedentary women (CS; n = 8). The CA and AA women were not significantly different in body composition, exercise training, psychometric tests, or dietary consumption. The CA women had shorter luteal phases (P less than 0.05) and lower urinary excretion of pregnanediol glucuronide than the CS women. In the AA women, urinary estrone glucuronide, pregnanediol glucuronide, and LH excretion were low throughout a 30-day period. The CA women had a 24-h pattern of pulsatile LH secretion characterized by reduced frequency (P less than 0.05) and increased amplitude (P less than 0.05), yielding an overall increased 24-h mean level (P less than 0.05), but interpulse intervals similar to those in the CS women. During sleep, LH pulse frequency slowed in the CS and CA women, while pulse amplitude increased and the mean serum LH level decreased in both groups. The AA women had even fewer pulses (P less than 0.05) of normal amplitude occurring at much more variable (P less than 0.01) interpulse intervals. Sleep-associated changes in LH pulsatility were absent. Responses to a 10-microgram bolus GnRH dose revealed blunted (P less than 0.05) FSH release in CA and augmented (P less than 0.05) LH release in AA women. The groups did not differ in any 24-h ACTH pulse pattern parameter or in cortisol pulse frequencies. Yet, early morning (0200-0800 h) serum cortisol levels were higher (P less than 0.05) in both groups of athletes, and this elevation was extended through the day (0800-2000 h; P less than 0.001) and evening (2000-0200 h; P less than 0.05) in the AA women. The plasma ACTH and serum cortisol responses to bolus human CRH administration were blunted in the CA and AA women [change from baseline (delta) in ACTH, P less than 0.05 and P less than 0.01; delta cortisol, P less than 0.01 and P less than 0.01, respectively], but adrenal sensitivity (delta cortisol/delta ACTH ratio) was increased (P less than 0.05). The plasma ACTH and serum cortisol responses to meals also were blunted in the athletic groups (P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)
通过测定月经周期规律的运动女性（CA组；n = 9）、闭经的运动女性（AA组；n = 9）和月经周期规律的久坐女性（CS组；n = 8）卵泡早期促黄体生成素（LH）、促肾上腺皮质激素（ACTH）和皮质醇的脉冲式分泌，评估下丘脑 - 垂体 - 卵巢轴和下丘脑 - 垂体 - 肾上腺轴的功能完整性。CA组和AA组女性在身体成分、运动训练、心理测试或饮食摄入方面无显著差异。与CS组女性相比，CA组女性的黄体期较短（P < 0.05），尿中孕二醇葡萄糖醛酸苷排泄较低。在AA组女性中，整个30天期间尿中雌酮葡萄糖醛酸苷、孕二醇葡萄糖醛酸苷和LH排泄均较低。CA组女性24小时LH脉冲式分泌模式的特点是频率降低（P < 0.05）、幅度增加（P < 0.05），导致24小时平均水平总体升高（P < 0.05），但脉冲间期与CS组女性相似。睡眠期间，CS组和CA组女性的LH脉冲频率减慢，而两组的脉冲幅度均增加，血清LH平均水平均降低。AA组女性的正常幅度脉冲更少（P < 0.05），脉冲间期变化更大（P < 0.01）。睡眠相关的LH脉冲性变化不存在。对10微克促性腺激素释放激素（GnRH）推注剂量的反应显示，CA组女性促卵泡生成素（FSH）释放减弱（P < 0.05），AA组女性LH释放增强（P < 0.05）。各组在任何24小时ACTH脉冲模式参数或皮质醇脉冲频率方面均无差异。然而，两组运动员的清晨（02:00 - 08:00时）血清皮质醇水平均较高（P < 0.05），且AA组女性这种升高持续至白天（08:00 - 20:00时；P < 0.001）和晚上（20:00 - 02:00时；P < 0.05）。CA组和AA组女性对促肾上腺皮质激素释放激素（CRH）推注给药的血浆ACTH和血清皮质醇反应减弱[ACTH相对于基线的变化（Δ），P < 0.05和P < 0.01；Δ皮质醇，分别为P < 0.01和P < 0.01]，但肾上腺敏感性（Δ皮质醇/ΔACTH比值）增加（P < 0.05）。运动组对进餐的血浆ACTH和血清皮质醇反应也减弱（P < 0.05）。（摘要截选至400字）
