Buchanan C R, Stanhope R, Adlard P, Jones J, Grant D B, Preece M A
Department of Growth and Development, Institute of Child Health, London, UK.
Clin Endocrinol (Oxf). 1988 Oct;29(4):427-36. doi: 10.1111/j.1365-2265.1988.tb02892.x.
We have studied eight children with primary hypothyroidism (6F, 2M) aged 6.7 to 14.2 years. The girls were prepubertal and the boys had early normal pubertal development. Overnight secretion of LH, FSH, TSH, PRL and GH, and ovarian ultrasound morphology were assessed before and up to 9 months after commencing thyroxine treatment. Serum FSH concentrations in all the girls were increased above LH levels and severe hypothyroidism was associated with reduced GH secretion. These abnormalities reversed with thyroxine treatment. The boys had less severe hypothyroidism and did not demonstrate abnormal gonadotropin or GH secretion. We conclude that primary hypothyroidism in childhood is associated with widespread disturbance of pituitary function, including increased FSH secretion often without signs of early sexual maturation.
我们研究了8名原发性甲状腺功能减退症患儿(6名女孩,2名男孩),年龄在6.7至14.2岁之间。女孩处于青春期前,男孩青春期发育早期正常。在开始甲状腺素治疗前及治疗后长达9个月的时间里,评估了促黄体生成素(LH)、促卵泡生成素(FSH)、促甲状腺激素(TSH)、催乳素(PRL)和生长激素(GH)的夜间分泌情况,以及卵巢超声形态。所有女孩的血清FSH浓度均高于LH水平,严重甲状腺功能减退与GH分泌减少有关。这些异常情况在甲状腺素治疗后得到逆转。男孩的甲状腺功能减退症较轻,未表现出促性腺激素或GH分泌异常。我们得出结论,儿童原发性甲状腺功能减退症与垂体功能的广泛紊乱有关,包括FSH分泌增加,且往往没有早期性成熟的迹象。