Vermesh M, Silva P D, Rosen G F, Vijod A G, Lobo R A
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles.
J Clin Endocrinol Metab. 1988 Jan;66(1):128-30. doi: 10.1210/jcem-66-1-128.
Ovarian hyperandrogenism may induce adrenal enzymatic defects that mimic true inherited disorders of adrenal hormone biosynthesis. To assess the effect of hyperandrogenism on adrenal steroidogenesis, seven normal ovulatory women were studied on 2 days during the early follicular phase of their cycles. Plasma 17-hydroxyprogesterone (17-Prog), 17-hydroxypregnenolone, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione (Adione), testosterone (T), 11-deoxycortisol, and cortisol concentrations were measured every 15 min for 3 h after iv injection of 0.25 mg ACTH (day 1) and pretreatment with dexamethasone on each day. On the second study day, T (80 micrograms/h) was infused iv for 5 h, and ACTH was given after 2 h of T infusion. The T infusion raised mean serum T levels from 1.2 +/- 0.3 (+/- SE) to 8.6 +/- 0.6 nmol/L. The maximum incremental (delta max) plasma Adione response to ACTH was significantly higher (2.6 +/- 0.3 to 3.2 +/- 0.4 nmol/L; P less than 0.009) during the T infusion, while the delta max responses of the other steroids did not change. There was an increase in the delta max 17-Prog to cortisol ratio (4.9 +/- 0.7 to 7.0 +/- 1.0; P less than 0.05), but no change in the delta max 17-Prog to Adione or 17-hydroxypregnenolone to DHEA ratios and no changes in the delta max delta 5- to delta 4-steroid ratios. These data suggest that acute T elevations result in subtle inhibition of 21-and/or 11 beta-hydroxylase activities, but not in 17-20-desmolase or 3 beta-ol activities.
卵巢雄激素过多可能会诱发肾上腺酶缺陷，这些缺陷类似于真正遗传性的肾上腺激素生物合成障碍。为了评估雄激素过多对肾上腺类固醇生成的影响，对7名正常排卵的女性在其月经周期的卵泡早期的2天进行了研究。在静脉注射0.25mg促肾上腺皮质激素（第1天）并在每天进行地塞米松预处理后，每15分钟测量一次血浆17-羟孕酮（17-Prog）、17-羟孕烯醇酮、脱氢表雄酮（DHEA）、硫酸脱氢表雄酮、雄烯二酮（Adione）、睾酮（T）、11-脱氧皮质醇和皮质醇浓度，持续3小时。在第二项研究日，静脉输注T（80微克/小时）5小时，并在T输注2小时后给予促肾上腺皮质激素。T输注使平均血清T水平从1.2±0.3（±SE）升高至8.6±0.6nmol/L。在T输注期间，血浆Adione对促肾上腺皮质激素的最大增量（delta max）反应显著更高（从2.6±0.3至3.2±0.4nmol/L；P＜0.009），而其他类固醇的delta max反应没有变化。delta max 17-Prog与皮质醇的比值增加（从4.9±0.7至7.0±1.0；P＜0.05），但delta max 17-Prog与Adione的比值或17-羟孕烯醇酮与DHEA的比值没有变化，delta max δ5-与δ4-类固醇的比值也没有变化。这些数据表明，急性T升高会导致21-和/或11β-羟化酶活性受到细微抑制，但不会导致17-20-裂解酶或3β-醇活性受到抑制。
