Röjdmark S, Berg A, Kallner G
Department of Internal Medicine II, Södersjukhuset, Stockholm, Sweden.
Horm Res. 1988;29(5-6):185-90. doi: 10.1159/000181000.
To test whether chronic thyroid hormone excess influences the hypothalamic-pituitary-testicular axis, 8 hyperthyroid men were given two identical intravenous GnRH tests. The first test was performed before any treatment had been instituted, the second 6-13 months later, when medical treatment had made the patients euthyroid. Although basal serum luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) levels were of similar magnitudes before and after the medical treatment, LH and FSH responsiveness to gonadotropin-releasing hormone (GnRH), as reflected by the hormone incremental areas (U/l X min), were significantly larger in the thyrotoxic state compared with the euthyroid state (LH incremental areas: 3,999 +/- 665 vs. 2,640 +/- 430, p less than 0.02; FSH incremental areas: 825 +/- 193 vs. 542 +/- 98, p less than 0.05). Furthermore, serum T increased significantly in response to GnRH when the patients were hyperthyroid (T incremental area: 162 +/- 51, p less than 0.02), but failed to do so when they were euthyroid (T incremental area: 92 +/- 53, NS). These results imply that chronic thyroid hormone excess makes the pituitary gonadotrophs 'hypersensitive' to exogenous GnRH. This may in turn explain why human Leydig cells respond more powerful to exogenous GnRH in thyrotoxic patients than in euthyroid subjects.
为了检测长期甲状腺激素过量是否会影响下丘脑-垂体-睾丸轴，对8名甲状腺功能亢进男性进行了两次相同的静脉注射促性腺激素释放激素（GnRH）试验。第一次试验在未进行任何治疗之前进行，第二次试验在6 - 13个月后进行，此时药物治疗已使患者甲状腺功能恢复正常。尽管药物治疗前后基础血清黄体生成素（LH）、卵泡刺激素（FSH）和睾酮（T）水平相似，但与甲状腺功能正常状态相比，甲状腺毒症状态下LH和FSH对促性腺激素释放激素（GnRH）的反应性（以激素增量面积表示，单位：U/l×min）显著更高（LH增量面积：3999±665 vs. 2640±430，p<0.02；FSH增量面积：825±193 vs. 542±98，p<0.05）。此外，患者甲状腺功能亢进时，血清T对GnRH有显著升高反应（T增量面积：162±51，p<0.02），而甲状腺功能正常时则无此反应（T增量面积：92±53，无统计学意义）。这些结果表明，长期甲状腺激素过量使垂体促性腺细胞对外源性GnRH“超敏”。这反过来可能解释了为什么甲状腺毒症患者的人类睾丸间质细胞对外源性GnRH的反应比甲状腺功能正常的受试者更强。
