Aedo A R, Landgren B M, Diczfalusy E
Contraception. 1981 Nov;24(5):543-58. doi: 10.1016/0010-7824(81)90058-5.
In an attempt to assess the effect of depot-medroxyprogesterone acetate (DMPA) on adrenal function, to peripheral levels of a variety of steroids were estimated after dexamethasone suppression and subsequent ACTH stimulation in 5 subjects. The steroid responses observed 16 and 54 days after a single injection of 150 mg of DMPA were compared with those obtained in the same women before DMPA treatment or with those found at different phases of the cycle in another group of 6 normally menstruating women. The levels of cortisol, pregnenolone, 17-hydroxypregnenolone, dehydroepiandrosterone, androstenedione and dihydrotestosterone were significantly suppressed by dexamethasone and stimulated by ACTH in all phases of the cycle, and before and after DMPA administration. The extent of suppression or stimulation (expressed as a percentage) was different in case of different steroids, but was rather constant with regard to the same steroid. Hence, the functional capacity of the adrenal as reflected by the levels of these steroids. Dexamethasone administration did not exert any influence on the levels of progesterone and 17-hydroxyprogesterone during the different phases of the cycle; however, ACTH administration increased the levels of these two steroids in the follicular phase and also after DMPA treatment. The levels of estradiol and lutropin were not influenced by dexamethasone or ACTH at any of the occasions studied. It is concluded that the functional capacity of the adrenal cortex is constant during the various cycle phases and is not affected by the administration of a single dose of 150 mg of DMPA.
为了评估醋酸甲羟孕酮长效注射剂(DMPA)对肾上腺功能的影响,对5名受试者在接受地塞米松抑制及随后促肾上腺皮质激素(ACTH)刺激后,外周血中多种类固醇的水平进行了测定。将单次注射150mg DMPA后16天和54天观察到的类固醇反应,与同一女性在DMPA治疗前获得的反应,或与另一组6名正常月经周期女性在月经周期不同阶段所发现的反应进行比较。在月经周期的所有阶段、DMPA给药前后,皮质醇、孕烯醇酮、17-羟孕烯醇酮、脱氢表雄酮、雄烯二酮和双氢睾酮的水平均被地塞米松显著抑制,并被ACTH刺激。不同类固醇的抑制或刺激程度(以百分比表示)不同,但同一种类固醇的情况相当稳定。因此,这些类固醇水平反映了肾上腺的功能能力。在月经周期的不同阶段,地塞米松给药对孕酮和17-羟孕酮的水平没有任何影响;然而,ACTH给药在卵泡期以及DMPA治疗后增加了这两种类固醇的水平。在任何研究的情况下,雌二醇和促黄体生成素的水平均不受地塞米松或ACTH的影响。结论是,肾上腺皮质的功能能力在月经周期的各个阶段是恒定的,且不受单次注射150mg DMPA的影响。