Baranowska B, Rozbicka G, Jeske W, Abdel-Fattah M H
J Clin Endocrinol Metab. 1984 Sep;59(3):412-6. doi: 10.1210/jcem-59-3-412.
The aim of this study was to evaluate the role of endogenous opiates in the mechanism of decreased LH secretion in women with anorexia nervosa. For this purpose the effect of opiate receptor blockade with naloxone on LH, FSH, PRL, and beta-endorphins secretion was studied in 24 women with anorexia nervosa and 7 normal women. Serum LH, FSH, PRL, beta-endorphin-like substance, ACTH, and cortisol concentrations were measured before and after opiate receptor blockade after a single iv dose of 0.2 mg/kg naloxone or saline. Mean serum LH and FSH concentrations increased significantly after naloxone in the normal women. Eleven patients had a significant increase in serum LH concentrations in response to naloxone and 13 did not respond to naloxone with an increase in LH concentration. In the first group the basal LH values were higher than those in the second group. In the majority of patients in the first group amenorrhea preceded the wt loss, whereas in most patients in the second group amenorrhea appeared during the phase of wt loss. Naloxone did not alter pulsatile LH secretion in 6 women. No effect of naloxone on serum FSH and PRL concentrations was found. A significant increase in beta-endorphin-like substance levels after naloxone administration occurred in patients with anorexia nervosa. However, serum ACTH and cortisol concentrations were not altered in response to naloxone. In conclusion, the increase in LH release after opiate receptor blockade by naloxone suggests that endogenous opiates may play a role in the mechanism of inhibited LH secretion at least, in the majority of those women with anorexia nervosa in whom amenorrhea preceded wt loss. The results also point to a different mechanism of ACTH and beta-endorphin secretion in patients with anorexia nervosa.
本研究的目的是评估内源性阿片类物质在神经性厌食症女性促黄体生成素（LH）分泌减少机制中的作用。为此，在24名神经性厌食症女性和7名正常女性中研究了用纳洛酮阻断阿片受体对LH、促卵泡生成素（FSH）、催乳素（PRL）和β-内啡肽分泌的影响。在单次静脉注射0.2mg/kg纳洛酮或生理盐水后，于阿片受体阻断前后测定血清LH、FSH、PRL、β-内啡肽样物质、促肾上腺皮质激素（ACTH）和皮质醇浓度。正常女性在注射纳洛酮后，血清LH和FSH平均浓度显著升高。11名患者对纳洛酮反应时血清LH浓度显著升高，13名患者对纳洛酮无反应，LH浓度未升高。第一组的基础LH值高于第二组。在第一组的大多数患者中，闭经先于体重减轻，而在第二组的大多数患者中，闭经出现在体重减轻阶段。纳洛酮对6名女性的LH脉冲式分泌无影响。未发现纳洛酮对血清FSH和PRL浓度有影响。神经性厌食症患者在给予纳洛酮后，β-内啡肽样物质水平显著升高。然而，血清ACTH和皮质醇浓度对纳洛酮无反应。总之，纳洛酮阻断阿片受体后LH释放增加表明，内源性阿片类物质可能至少在大多数闭经先于体重减轻的神经性厌食症女性的LH分泌抑制机制中起作用。结果还表明神经性厌食症患者ACTH和β-内啡肽分泌机制不同。
