Waldstreicher J, Santoro N F, Hall J E, Filicori M, Crowley W F
Department of Medicine, Vincent Research Laboratories, Massachusetts General Hospital, Boston 02114.
J Clin Endocrinol Metab. 1988 Jan;66(1):165-72. doi: 10.1210/jcem-66-1-165.
To examine gonadotropin secretory frequency as a component of the disordered neuroendocrine regulation of gonadotropin secretion in women with polycystic ovarian disease (PCOD), we measured serum gonadotropin concentrations in 12 women with PCOD at 10-min intervals for periods of 12-24 h. The patterns of LH and FSH release in these patients were compared to the findings of 24 studies in 21 age-matched normal women during the early, mid- and late follicular phases (EFP, MFP and LFP) of their cycles. Serum sex steroid levels during the 12-24 h of study in the women with PCOD were compared to those in normal women studied during the follicular phase. The mean serum estradiol (E2) level in the women with PCOD was similar to that in normal women studied in the EFP, but lower than those in normal women in the MFP (P less than 0.05) and LFP (P less than 0.01). Mean serum estrone, however, was significantly higher in women with PCOD than in women in the EFP and MFP (P less than 0.05 and P less than 0.02, respectively), but lower than that in women in the LFP (P less than 0.02). Total and unbound testosterone (T) levels were significantly elevated in women with PCOD compared to those in normal women at all stages of the follicular phase (P less than 0.001). The mean serum LH concentration and LH pulse amplitude were markedly elevated in the women with PCOD compared to normal women at all three stages of the follicular phase (P less than 0.05 or less). In addition, LH pulse frequency was faster in women with PCOD [24.8 +/- 0.9 ( +/- SE) pulses/24 h] than that in women in the EFP (15.6 +/- 0.7; P less than 0.01), MFP (22.2 +/- 1.1; P less than 0.05) and LFP (20.8 +/- 1.2; P less than 0.01). This increased LH pulse frequency in women with PCOD correlated with ambient serum E2 levels on the day of study (r = 0.84; P less than 0.001), but not with serum estrone, T, or unbound T. Repeat studies in four women with PCOD demonstrated a similarly abnormal gonadotropin secretory pattern in each. We conclude that 1) women with PCOD have an increase in both the amplitude and frequency of LH secretion compared to those in normally cycling women throughout the follicular phase; 2) the defect in women with PCOD is reproducible.(ABSTRACT TRUNCATED AT 400 WORDS)
为了研究促性腺激素分泌频率，作为多囊卵巢疾病（PCOD）女性促性腺激素分泌神经内分泌调节紊乱的一个组成部分，我们对12例PCOD女性每隔10分钟测量一次血清促性腺激素浓度，持续12 - 24小时。将这些患者的LH和FSH释放模式与21例年龄匹配的正常女性在其月经周期卵泡期早期、中期和晚期（EFP、MFP和LFP）的24项研究结果进行比较。将PCOD女性研究期间12 - 24小时的血清性类固醇水平与卵泡期研究的正常女性的水平进行比较。PCOD女性的平均血清雌二醇（E2）水平与EFP期研究的正常女性相似，但低于MFP期（P<0.05）和LFP期（P<0.01）的正常女性。然而，PCOD女性的平均血清雌酮显著高于EFP期和MFP期的女性（分别为P<0.05和P<0.02），但低于LFP期的女性（P<0.02）。与卵泡期各阶段的正常女性相比，PCOD女性的总睾酮和游离睾酮（T）水平显著升高（P<0.001）。与卵泡期三个阶段的正常女性相比，PCOD女性的平均血清LH浓度和LH脉冲幅度均显著升高（P<0.05或更低）。此外，PCOD女性的LH脉冲频率[24.8±0.9（±SE）次/24小时]比EFP期女性（15.6±0.7；P<0.01）、MFP期女性（22.2±1.1；P<0.05）和LFP期女性（20.8±1.2；P<0.01）更快。PCOD女性这种增加的LH脉冲频率与研究当天的周围血清E2水平相关（r = 0.84；P<0.001），但与血清雌酮、T或游离T无关。对4例PCOD女性的重复研究表明，每例患者的促性腺激素分泌模式同样异常。我们得出结论：1）与整个卵泡期正常月经周期的女性相比，PCOD女性的LH分泌幅度和频率均增加；2）PCOD女性的缺陷是可重复的。（摘要截短至400字）
