Vigersky R A, Andersen A E, Thompson R H, Loriaux D L
N Engl J Med. 1977 Nov 24;297(21):1141-5. doi: 10.1056/NEJM197711242972103.
We tested hypothalamic, pituitary and endocrine function in 19 patients with secondary amenorrhea associated with simple weight loss who did not have anorexia nervosa to evaluate the effects of weight loss on these systems. Thermoregulation at 10 degrees C and 49 degrees C was abnormal and correlated with the percentage below ideal body weight (r = 0.62, P less than 0.02, and r = 0.55, P less than 0.05, respectively). Partial diabetes insipidus was found in 27 per cent of patients with simple weight loss. They had delayed peak plasma luteinizing hormone levels after 10 microgram of luteinizing-hormone-releasing factor, which was correlated with percentage below ideal body weight (r = 0.49, P less than 0.05). Delayed peak plasma thyrotropin levels after 500 microgram of thyrotropin-releasing factor were found. No prolactin, pituitary, thyroid or adrenal abnormalities were present. These findings are qualitatively similar to results of studies in 29 patients with anorexia nervosa, but less severe and less frequently present. We conclude that hypothalamic dysfunction may be caused by weight loss per se.
我们对19例继发于单纯体重减轻且无神经性厌食症的继发性闭经患者的下丘脑、垂体及内分泌功能进行了检测，以评估体重减轻对这些系统的影响。在10摄氏度和49摄氏度时体温调节异常，且与低于理想体重的百分比相关（分别为r = 0.62，P < 0.02，以及r = 0.55，P < 0.05）。27%的单纯体重减轻患者存在部分性尿崩症。给予10微克促黄体生成素释放因子后，他们的血浆促黄体生成素峰值延迟，这与低于理想体重的百分比相关（r = 0.49，P < 0.05）。给予500微克促甲状腺激素释放因子后，发现血浆促甲状腺激素峰值延迟。未发现催乳素、垂体、甲状腺或肾上腺异常。这些发现与对29例神经性厌食症患者的研究结果在性质上相似，但程度较轻且出现频率较低。我们得出结论，下丘脑功能障碍可能由体重减轻本身引起。
