Department of Growth and ReproductionRigshospitalet, University of Copenhagen, Copenhagen, Denmark.
International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC)Rigshospitalet, Denmark.
Eur J Endocrinol. 2017 Apr;176(4):379-391. doi: 10.1530/EJE-16-0912. Epub 2017 Jan 11.
Gonadotropin-releasing hormone (GnRH) and human chorionic gonadotropin (hCG) stimulation tests may be used to evaluate the pituitary and testicular capacity. Our aim was to evaluate changes in follicular-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone after GnRH and hCG stimulation in healthy men and assess the impact of six single nucleotide polymorphisms on the responses.
GnRH and hCG stimulation tests were performed on 77 healthy men, 18-40 years (reference group) at a specialized andrology referral center at a university hospital. The potential influence of the tests was illustrated by results from 45 patients suspected of disordered hypothalamic-pituitary-gonadal axis.
Baseline, stimulated, relative and absolute changes in serum FSH and LH were determined by ultrasensitive TRIFMA, and testosterone was determined by LC-MS/MS.
For the reference group, LH and FSH increased almost 400% and 40% during GnRH testing, stimulated levels varied from 4.4 to 58.8 U/L and 0.2 to 11.8 U/L and FSH decreased in nine men. Testosterone increased approximately 110% (range: 18.7-67.6 nmol/L) during hCG testing. None of the polymorphisms had any major impact on the test results. Results from GnRH and hCG tests in patients compared with the reference group showed that the stimulated level and absolute increase in LH showed superior identification of patients compared with the relative increase, and the absolute change in testosterone was superior in identifying men with Leydig cell insufficiency, compared with the relative increase.
We provide novel reference ranges for GnRH and hCG test in healthy men, which allows future diagnostic evaluation of hypothalamic-pituitary-gonadal disorders in men.
促性腺激素释放激素（GnRH）和人绒毛膜促性腺激素（hCG）刺激试验可用于评估垂体和睾丸的功能。我们的目的是评估 GnRH 和 hCG 刺激后健康男性的卵泡刺激素（FSH）、黄体生成素（LH）和睾酮的变化，并评估六个单核苷酸多态性对这些反应的影响。
在大学医院的一家专门的男科转诊中心，对 77 名 18-40 岁的健康男性（参考组）进行了 GnRH 和 hCG 刺激试验。通过对 45 名疑似下丘脑-垂体-性腺轴紊乱的患者的检测结果，说明了这些检测的潜在影响。
通过超灵敏 TRIFMA 测定血清 FSH 和 LH 的基础、刺激、相对和绝对变化，采用 LC-MS/MS 测定睾酮。
对于参考组，在 GnRH 检测过程中，LH 和 FSH 增加了近 400%和 40%，刺激水平在 4.4 至 58.8 U/L 和 0.2 至 11.8 U/L 之间变化，有 9 名男性的 FSH 下降。在 hCG 检测过程中，睾酮增加了约 110%（范围：18.7-67.6 nmol/L）。这些多态性均未对检测结果产生重大影响。与参考组相比，患者的 GnRH 和 hCG 检测结果显示，与相对增加相比，LH 的刺激水平和绝对增加更能识别患者，而与相对增加相比，睾酮的绝对变化更能识别莱迪希细胞功能不全的男性。
我们为健康男性提供了 GnRH 和 hCG 检测的新参考范围，这使得未来可以对男性的下丘脑-垂体-性腺功能障碍进行诊断评估。
