Unzer S R, dos Santos J E, Moreira A C, Vilanova M S, de Sá M F
Department of Gynecology and Obstetrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
J Reprod Med. 1995 Jul;40(7):516-20.
To evaluate the alterations in plasma gonadotropin and sex steroid levels in obesity.
A study was conducted on 77 obese women, 30 with ovulatory menstrual cycles (group I) and 47 with chronic anovulation (group II), who were compared to 15 women of normal weight and with ovulatory cycles (group C). Obesity was determined on the basis of body mass index. Blood samples were obtained during the follicular phase of the cycle for measurement of follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), testosterone (T), androstenedione (A), dehydroepiandrosterone sulfate (DHEAS), estrone (E1) and estradiol (E2).
Elevated LH, T, A and E1 levels were detected in group II when compared to group I and group C. A levels were also elevated (P < or = .05) in group I when compared to group C. There was no significant difference between the three groups in FSH, PRL, DHEAS or E2 levels.
The elevated A levels in group I obese women show that even when ovulating, obese women are hyperandrogenic. This excessive A may activate the aromatizing system in adipose tissue, generating E1. When this occurs, the increase in E1 may trigger an increase in LH, with consequent ovarian hyperstimulation, leading to increased T and anovulatory cycles.
评估肥胖患者血浆促性腺激素和性激素水平的变化。
对77名肥胖女性进行了研究，其中30名有排卵性月经周期（第一组），47名有慢性无排卵（第二组），并与15名体重正常且有排卵周期的女性（C组）进行比较。根据体重指数确定肥胖情况。在月经周期的卵泡期采集血样，以测量促卵泡激素（FSH）、促黄体生成素（LH）、催乳素（PRL）、睾酮（T）、雄烯二酮（A）、硫酸脱氢表雄酮（DHEAS）、雌酮（E1）和雌二醇（E2）。
与第一组和C组相比，第二组检测到LH、T、A和E1水平升高。与C组相比，第一组的A水平也升高（P≤0.05）。三组在FSH、PRL、DHEAS或E2水平上无显著差异。
第一组肥胖女性的A水平升高表明，即使在排卵时，肥胖女性也存在高雄激素血症。这种过量的A可能会激活脂肪组织中的芳香化系统，产生E1。当这种情况发生时，E1的增加可能会引发LH的增加，进而导致卵巢过度刺激，导致T增加和无排卵周期。
