Öztin Hasan, Çağıltay Eylem, Çağlayan Sinan, Kaplan Mustafa, Akpak Yaşam Kemal, Karaca Nilay, Tığlıoğlu Mesut
a Internal Diseases Department , Gülhane Military Medical Academy Military Faculty of Medicine Hospital, Geriatrics Clinic , Ankara , Turkey.
b İzmir Military Hospital, Internal Diseases Clinic , Izmir , Turkey.
Gynecol Endocrinol. 2016 Dec;32(12):991-994. doi: 10.1080/09513590.2016.1214258. Epub 2016 Sep 10.
Male hypogonadism is defined as the deficiency of testosterone or sperm production synthesized by testicles or the deficiency of both. The reasons for hypogonadism may be primary, meaning testicular or secondary, meaning hypothalamohypophyseal. In hypogonadotropic hypogonadism (HH), there is indeficiency in gonadotropic hormones due to hypothalamic or hypophyseal reasons. Gonadotropin-releasing hormone (GnRH) is an important stimulant in releasing follicular stimulant hormone (FSH), mainly luteinizing hormone (LH). GnRH omitted is under the effect of many hormonal or stimulating factors. Kisspeptin is present in many places of the body, mostly in hypothalamic anteroventral periventricular nucleus and arcuate nucleus. Kisspeptin has a suppressor effect on the metastasis of many tumors such as breast cancer and malign melanoma metastases, and is called "metastin" for this reason. Kisspeptin is a strong stimulant of GnRH. In idiopathic hypogonadotropic hypogonadism (IHH) etiology, there is gonadotropic hormone release indeficiency which cannot be clearly described. A total of 30 male hypogonatropic hypogonadism diagnosed patients over 30 years of age who have applied to Haydarpasa Education Hospital Endocrinology and Metabolic Diseases Service were included in the study. Compared to the control group, the effect of kisspeptin on male patients with hypogonatropic hypogonadism and on insulin resistance developing in hypogonadism patients was investigated in our study. A statistically significant difference was detected between average kisspeptin measurements of the groups (p < 0.01). Kisspeptin measurement of the cases in the patient group were detected significantly high. No statistically significant relation was detected among kisspeptin and LH/FSH levels. Although a positive low relation was detected between kisspeptin measurements of patient group cases and homeostasis model assessment of insulin resistance (HOMA-IR) measurements, this relation was statistically insignificant. When the patient and control groups were compared for HOMA-IR, no statistically significant difference was detected. The reason for high kisspeptin levels in the patient group compared to the control group makes us consider that there may be a GPR54 resistance or GnRH neuronal transfer pathway defect. When patients and control groups were compared for HOMA-IR, the difference was not statistically significant. It is considered that kisspeptin is one of the reasons for hypogonatropic hypogonadism and has less effect on insulin resistance.
男性性腺功能减退被定义为睾丸合成的睾酮或精子生成不足，或两者均不足。性腺功能减退的原因可能是原发性的，即睾丸原因，或继发性的，即下丘脑 - 垂体原因。在低促性腺激素性性腺功能减退（HH）中，由于下丘脑或垂体原因，促性腺激素缺乏。促性腺激素释放激素（GnRH）是释放卵泡刺激素（FSH），主要是黄体生成素（LH）的重要刺激物。GnRH的分泌受多种激素或刺激因素的影响。 kisspeptin存在于身体的许多部位，主要在下丘脑室旁前腹核和弓状核。 kisspeptin对许多肿瘤如乳腺癌和恶性黑色素瘤转移的转移有抑制作用，因此被称为“metastin”。 kisspeptin是GnRH的强刺激物。在特发性低促性腺激素性性腺功能减退（IHH）病因中，存在无法明确描述的促性腺激素释放不足。本研究纳入了30例30岁以上申请海达尔帕萨教育医院内分泌和代谢疾病科的男性低促性腺激素性性腺功能减退患者。在我们的研究中，与对照组相比，研究了kisspeptin对男性低促性腺激素性性腺功能减退患者以及性腺功能减退患者中发生的胰岛素抵抗的影响。两组的平均kisspeptin测量值之间检测到统计学上的显著差异（p <0.01）。患者组病例的kisspeptin测量值明显较高。在kisspeptin与LH / FSH水平之间未检测到统计学上的显著关系。虽然在患者组病例的kisspeptin测量值与胰岛素抵抗稳态模型评估（HOMA-IR）测量值之间检测到低的正相关关系，但这种关系在统计学上不显著。当比较患者组和对照组的HOMA-IR时，未检测到统计学上的显著差异。与对照组相比，患者组中kisspeptin水平高的原因使我们认为可能存在GPR54抵抗或GnRH神经元传递途径缺陷。当比较患者组和对照组的HOMA-IR时，差异无统计学意义。认为kisspeptin是低促性腺激素性性腺功能减退的原因之一，对胰岛素抵抗的影响较小。
