Sluijmer A V, Heineman M J, De Jong F H, Evers J L
Department of Obstetrics and Gynecology, De Wever Ziekenhuis, Heerlen, The Netherlands.
J Clin Endocrinol Metab. 1995 Jul;80(7):2163-7. doi: 10.1210/jcem.80.7.7608272.
The endocrine activity of the postmenopausal ovary and the effect of pituitary down-regulation were studied in a group of 35 postmenopausal women. All women underwent oophorectomy with or without hysterectomy. Fifteen women received a single dose of a depot GnRH agonist (GnRHa) 2 weeks before operation, whereas 20 women formed the control group. Peripheral venous levels of LH, FSH, estrone, 17 beta-estradiol, testosterone (T), androstenedione (A), sex hormone-binding globulin, and dehydroepiandrosterone sulfate were measured 2 weeks before, during, and 6 weeks after surgery. Ovarian venous blood was sampled during surgery. In the GnRHa and control groups, ovarian venous levels of A and T were significantly higher, and those of dehydroepiandrosterone sulfate and sex hormone-binding globulin significantly lower, compared to the peripheral levels. A significant decrease in T was found in the peripheral and ovarian vein samples during pituitary down-regulation with GnRHa. Six weeks after operation, peripheral T levels were significantly lower than those during surgery in the group that was down-regulated at the time of oophorectomy. We conclude that the postmenopausal ovary produces significant amounts of A and T, although only T contributes significantly to its peripheral serum levels. T production by the postmenopausal ovary is in part stimulated by the high levels of circulating gonadotropins, although pituitary down-regulation does not completely abolish androgenic activity.
对一组35名绝经后女性研究了绝经后卵巢的内分泌活性以及垂体降调节的影响。所有女性均接受了有或无子宫切除术的卵巢切除术。15名女性在手术前2周接受了单剂量长效GnRH激动剂（GnRHa），而20名女性组成对照组。在手术前2周、手术期间和手术后6周测量外周静脉血中LH、FSH、雌酮、17β-雌二醇、睾酮（T）、雄烯二酮（A）、性激素结合球蛋白和硫酸脱氢表雄酮的水平。手术期间采集卵巢静脉血。与外周水平相比，GnRHa组和对照组中，卵巢静脉血中A和T的水平显著更高，而硫酸脱氢表雄酮和性激素结合球蛋白的水平显著更低。在使用GnRHa进行垂体降调节期间，外周血和卵巢静脉血样本中的T显著下降。在卵巢切除术时接受降调节的组中，术后6周外周T水平显著低于手术期间。我们得出结论，绝经后卵巢产生大量的A和T，尽管只有T对其外周血清水平有显著贡献。绝经后卵巢的T产生部分受循环中促性腺激素高水平的刺激，尽管垂体降调节并未完全消除雄激素活性。
