McKenna T J, Lorber D, Lacroix A, Rabin D
Acta Endocrinol (Copenh). 1979 Jul;91(3):501-10. doi: 10.1530/acta.0.0910501.
Plasma testosterone levels were suppressed in 6 of 8 mature male patients with Cushing's disease, all of whom complained of loss of libido and decreased sexual potency. Gonadotrophin levels, both under basal conditions and in response to LH-RH, were generally normal. The testicular response to stimulation with hCG was brisk in the 2 patients examined. Oestradiol levels were slightly elevated in 2 patients and prolactin levels were normal in all patients. Thus, male patients with Cushing's disease demonstrated normal gonadotrophin levels in the presence of suppressed testosterone, or, viewed from a slightly different prospect, low testosterone levels despite normal gonadotrophins. Neither oestradiol nor prolactin excess appeared to account for the observations. Possible explanations for these findings include (a) a combination of impaired hypothalamic and testicular function, and (b) a resetting downwards of the level of testosterone that is seen as appropriate by the disordered bypothalamic-pituitary unit. Following correction of cortisol excess in Cushing's disease, testosterone levels rose into the normal range.
8例成年男性库欣病患者中有6例血浆睾酮水平受到抑制，所有这些患者均主诉性欲丧失和性功能减退。促性腺激素水平，无论是在基础状态下还是对促黄体生成素释放激素（LH-RH）的反应中，通常都是正常的。接受检查的2例患者对人绒毛膜促性腺激素（hCG）刺激的睾丸反应活跃。2例患者雌二醇水平略有升高，所有患者催乳素水平均正常。因此，库欣病男性患者在睾酮受到抑制的情况下表现出正常的促性腺激素水平，或者，从略有不同的角度来看，尽管促性腺激素正常，但睾酮水平较低。雌二醇和催乳素水平升高似乎都不能解释这些观察结果。这些发现的可能解释包括：（a）下丘脑和睾丸功能受损的综合作用；（b）紊乱的下丘脑-垂体单位认为适当的睾酮水平向下重置。库欣病患者皮质醇过多得到纠正后，睾酮水平升至正常范围。
