Pizzi A, Fusi S, Forti G, Marconi G
Ital J Neurol Sci. 1985 Dec;6(4):457-67. doi: 10.1007/BF02331039.
Endocrine function was studied in 12 patients, 7 men and 5 women, with myotonic dystrophy (MD). Growth hormone (GH) was within normal limits in all the patients and there was no response to arginine stimulation. Prolactin (PRL) was above normal in only 2 cases (one man and one woman) and the response to TRH was below normal in 2 patients and slightly above in one. The GnRH test yielded a reduced LH response in 4 of the 7 men and none at all in the 4 women in whom it was done. The FSH response was below normal in only one of the 7 men and in 3 out of 4 women. The testosterone assay after HCG stimulation was borderline high in 2 out of 6 men and below normal in one. The level of thyroid hormones (T3, T4, FTI, TSH) was normal in all patients except one, whose FTI and T4 level were below normal. In the TRH test TSH was raised in only one of the 6 patients tested. The circadian rhythm of cortisol was absent in 3 out of 10 patients and 3 out of 8 patients showed no response to ACTH stimulation. The results of the study suggest that endocrine alterations are fairly frequent in MD but that they are neither specific nor correlated with disease severity or duration.
对12例患有强直性肌营养不良(MD)的患者(7名男性和5名女性)的内分泌功能进行了研究。所有患者的生长激素(GH)均在正常范围内,且对精氨酸刺激无反应。仅2例患者(1名男性和1名女性)的催乳素(PRL)高于正常水平,2例患者对促甲状腺激素释放激素(TRH)的反应低于正常水平,1例略高于正常水平。促性腺激素释放激素(GnRH)试验显示,7名男性中有4名的促黄体生成素(LH)反应降低,4名接受该试验的女性均无反应。7名男性中只有1名、4名女性中有3名的促卵泡生成素(FSH)反应低于正常水平。6名男性中有2名在人绒毛膜促性腺激素(HCG)刺激后的睾酮测定值临界偏高,1名低于正常水平。除1例患者的游离甲状腺指数(FTI)和甲状腺素(T4)水平低于正常外,所有患者的甲状腺激素(T3、T4、FTI、促甲状腺激素(TSH))水平均正常。在TRH试验中,6名接受测试的患者中只有1名的TSH升高。10名患者中有3名的皮质醇昼夜节律消失,8名患者中有3名对促肾上腺皮质激素(ACTH)刺激无反应。研究结果表明,MD患者中内分泌改变相当常见,但这些改变既不具有特异性,也与疾病严重程度或病程无关。