Karibe C, Tamai H, Kiyohara K, Kobayashi N, Nakagawa T
Department of Psychosomatic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Acta Psychiatr Scand. 1988 Oct;78(4):442-7. doi: 10.1111/j.1600-0447.1988.tb06364.x.
Although prolactin (PRL) responses to thyrotropin-releasing hormone (TRH) have been described by many investigators, PRL secretion after insulin stimulation has rarely been documented in patients with anorexia nervosa (AN). We investigated PRL responses to TRH (500 micrograms) and insulin (0.1 U/kg) in 19 women with AN and 10 normal women. Levels of PRL stimulation at 60 min and later following insulin administration were significantly lower in AN than in normal women. PRL increased by at least 10 micrograms/ml after insulin in 42% of women with AN and in 70% of normal women. The maximum PRL increase (max delta PRL) did not differ after the two stimulations in the normal women. However, in AN, the max delta PRL after insulin stimulation (17.2 +/- 4.0 micrograms/l, mean +/- SEM) was significantly lower than that after TRH (49.1 +/- 6.4 micrograms/l). These findings suggest that anorectic women may have a disturbance in hypothalamic functions. Insulin-induced hypoglycemia is useful to determine the integrity of the hypothalamic-pituitary axis for PRL secretion, in combination with TRH stimulation.
尽管许多研究者都描述过催乳素（PRL）对促甲状腺激素释放激素（TRH）的反应，但神经性厌食症（AN）患者胰岛素刺激后的PRL分泌情况鲜有文献记载。我们对19名患AN的女性和10名正常女性进行了研究，观察她们对TRH（500微克）和胰岛素（0.1单位/千克）的反应。AN患者在注射胰岛素后60分钟及之后的PRL刺激水平显著低于正常女性。42%的患AN女性和70%的正常女性在注射胰岛素后PRL升高至少10微克/毫升。正常女性在两种刺激后PRL的最大升高值（最大PRL变化量）没有差异。然而，在AN患者中，胰岛素刺激后的最大PRL变化量（17.2±4.0微克/升，均值±标准误）显著低于TRH刺激后的（49.1±6.4微克/升）。这些发现表明，患厌食症的女性可能存在下丘脑功能紊乱。胰岛素诱导的低血糖症结合TRH刺激，有助于确定下丘脑 - 垂体轴对PRL分泌的完整性。
