Lobo R A, March C M, Goebelsmann U, Mishell D R
J Clin Endocrinol Metab. 1982 Feb;54(2):320-4. doi: 10.1210/jcem-54-2-320.
17 beta-Estradiol (E2) pellet replacement therapy for oophorectomized women has been shown to be safe and effective. Some investigators have advocated the addition of testosterone (T) pellets for oophorectomized women. This study was carried out to measure the level of androgens in oophorectomized women with and without E2 pellets. The possible modulating role of E2 upon adrenal androgens was investigated as well as the effects of obesity on bound and unbound serum levels of E2 and T. Seven obese patients and eight nonobese normal patients with E2 pellets were compared to nine oophorectomized age- and weight-matched control women not receiving estrogen. Obese patients had higher levels of androstenediol (Adiol) and androstenedione (A) than nonobese patients, yet compared to oophorectomized controls, nonobese patients had higher levels of dehydroepiandrosterone sulfate (DHEA-S) and Adiol. As a group, patients with E2 pellets had higher levels of DHEA-S, Adiol A, and unbound T compared to oophorectomized controls, and their Adiol and total and unbound T levels were similar to those of premenopausal females. Obese patients had lower levels of total E2, yet a higher percentage of unbound E2, resulting in unbound E2 levels which were similar to those of the nonobese women. Unbound T was higher in obese patients compared to the nonobese women and oophorectomized controls. In conclusion, these data suggest that 1) there may be a modulating role of E2 on adrenal androgens exemplified by an increased serum level of delta 5-3 beta-ol androgens in women with E2 pellets, 2) supplemental T implants for oophorectomized women may not be necessary, and 3) obese women with pellets have higher levels of Adiol, A, and unbound T then nonobese women and therefore have a higher ratio of androgen to estrogen.
对于接受卵巢切除术的女性，17β-雌二醇（E2）颗粒替代疗法已被证明是安全有效的。一些研究人员主张为接受卵巢切除术的女性添加睾酮（T）颗粒。本研究旨在测量接受和未接受E2颗粒的卵巢切除术后女性的雄激素水平。研究了E2对肾上腺雄激素的可能调节作用以及肥胖对E2和T的结合型和非结合型血清水平的影响。将7名肥胖患者和8名接受E2颗粒的非肥胖正常患者与9名未接受雌激素的年龄和体重匹配的卵巢切除术后对照女性进行比较。肥胖患者的雄烯二醇（Adiol）和雄烯二酮（A）水平高于非肥胖患者，但与卵巢切除术后对照组相比，非肥胖患者的硫酸脱氢表雄酮（DHEA-S）和Adiol水平更高。与卵巢切除术后对照组相比，接受E2颗粒的患者总体上DHEA-S、Adiol A和非结合型T水平更高，且其Adiol以及总T和非结合型T水平与绝经前女性相似。肥胖患者的总E2水平较低，但非结合型E2的百分比更高，导致非结合型E2水平与非肥胖女性相似。与非肥胖女性和卵巢切除术后对照组相比，肥胖患者的非结合型T更高。总之，这些数据表明：1）E2可能对肾上腺雄激素有调节作用，表现为接受E2颗粒的女性血清中δ5-3β-醇雄激素水平升高；2）对于接受卵巢切除术的女性，补充T植入物可能没有必要；3）接受颗粒植入的肥胖女性的Adiol、A和非结合型T水平高于非肥胖女性，因此雄激素与雌激素的比例更高。
