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[男性青少年神经性厌食症。II. 心理神经内分泌学研究结果]

[Anorexia nervosa in male adolescents. II. Psychoneuroendocrinologic findings].

作者信息

Toifl K, Waldhauser F, Lischka A, Frisch H

机构信息

Universitätsklinik für Neuropsychiatrie des Kindes- und Jugendalters.

出版信息

Klin Padiatr. 1988 Jul-Aug;200(4):316-20. doi: 10.1055/s-2008-1033727.

Abstract

Female patients with anorexia nervosa (a.n.) are characterized by distinct endocrine features probably due to hypothalamic pituitary dysfunctions. There is only a limited number of case reports available on patients with a.n.; mostly with few data on hormones. In six male patients with a.n. we examined basal and stimulation values of several hormones performing three pituitary function tests. Basal and stimulated values of luteinizing hormone (LH) and of follicle stimulating hormone (FSH) after LHRH were low comparable to results in prepuberal boys. Similarly, testosterone levels in serum were also markedly reduced. By exploring the pituitary-thyroidal axis total T4 was diminished in one patient and at the lower limit in two patients; concentration of free T4 was in the normal range, while five of six subjects had reduced total T3 concentration and two of six patients showed increased reversed T3 levels; TBG concentration was always in the normal range. Basal TSH was normal, while in two patients the TSH stimulation levels after TRH were diminished; in all patients the TSH stimulation levels were found to be delayed. The basal levels of growth hormone were normal, but the growth hormone response after insulin was diminished in four patients. In all six patients basal prolactin (PRL) and PRL concentration after TRH stimulation was in the normal range. The neuroendocrine results in the six patients with a.n. confirm in males a similar hypothalamic-pituitary dysfunction as it is already known for female patients.

摘要

神经性厌食症(a.n.)女性患者具有独特的内分泌特征,这可能是由于下丘脑 - 垂体功能障碍所致。关于a.n.患者的病例报告数量有限;大多数报告中激素数据很少。在6例男性a.n.患者中,我们通过进行三项垂体功能测试,检测了几种激素的基础值和刺激值。促黄体生成素(LH)和促卵泡激素(FSH)在促性腺激素释放激素(LHRH)刺激后的基础值和刺激值较低,与青春期前男孩的结果相当。同样,血清睾酮水平也明显降低。通过探究垂体 - 甲状腺轴,1例患者总T4降低,2例患者处于下限;游离T4浓度在正常范围内,而6例受试者中有5例总T3浓度降低,6例患者中有2例反T3水平升高;甲状腺素结合球蛋白(TBG)浓度始终在正常范围内。基础促甲状腺激素(TSH)正常,但2例患者促甲状腺激素释放激素(TRH)刺激后的TSH刺激水平降低;在所有患者中,TSH刺激水平均延迟。生长激素基础水平正常,但4例患者胰岛素刺激后的生长激素反应降低。在所有6例患者中,基础催乳素(PRL)和TRH刺激后的PRL浓度均在正常范围内。6例a.n.男性患者的神经内分泌结果证实,其下丘脑 - 垂体功能障碍与已知的女性患者相似。

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