Ikeda Y, Tanaka I, Oki Y, Gemmma R, Morita H, Komatsu K, Yoshimi T
Second Department of Internal Medicine, Hamamatsu University School of Medicine, Japan.
Endocr J. 1993 Aug;40(4):387-92. doi: 10.1507/endocrj.40.387.
We studied plasma vasopressin concentrations during hypertonic saline infusions in 5 men with hypogonadism and 10 normal men to investigate the effect of gonadal steroid on hypothalamo-neurohypophyseal function. All the subjects received the infusion of 5% saline, and plasma vasopressin concentrations were determined by radioimmunoassay (RIA). Three of the 5 men were patients with isolated hypogonadotropic hypogonadism (IHH) and the other two were patients with Klinefelter's syndrome. None of them had any symptoms of diabetes insipidus. Although there was no difference between basal plasma osmolality in the patients and the normal subjects (287.2 +/- 2.1 vs. 285.3 +/- 1.8 mmol/kg), the basal level of plasma vasopressin in the patients was lower than that in the normal subjects (0.62 +/- 0.17 vs. 1.36 +/- 0.15 pg/ml, P < 0.05). Hypertonic saline infusion revealed varying degrees of subnormal vasopressin responses in the patients except one patient with Klinefelter's syndrome. The mean vasopressin response to osmotic stimuli (delta plasma vasopressin/delta plasma osmolality) in the 5 patients was lower than in the normal subjects (0.04 +/- 0.01 vs. 0.16 +/- 0.02, P < 0.05). Three patients with IHH and one patient with Klinefelter's syndrome were re-examined after pulsatile gonadotropin-releasing hormone (GnRH) infusion or testosterone enanthate i.m. injection. After the treatment with testosterone or GnRH, the response of plasma vasopressin to hypertonic saline infusion was normalized in three patients who had subnormal vasopressin response before treatment (delta plasma vasopressin/delta plasma osmolality: 0.04 +/- 0.01 vs. 0.09 +/- 0.01, P < 0.05). These results suggest that testosterone improves the subnormal vasopressin response to osmotic stimuli in men with hypogonadism.
我们研究了5名性腺功能减退男性和10名正常男性在输注高渗盐水期间的血浆血管加压素浓度，以探讨性腺类固醇对下丘脑 - 神经垂体功能的影响。所有受试者均接受5%盐水输注，并通过放射免疫分析（RIA）测定血浆血管加压素浓度。5名男性中有3名是孤立性促性腺激素缺乏性性腺功能减退（IHH）患者，另外两名是克兰费尔特综合征患者。他们均无尿崩症症状。虽然患者和正常受试者的基础血浆渗透压无差异（287.2±2.1对285.3±1.8 mmol/kg），但患者的血浆血管加压素基础水平低于正常受试者（0.62±0.17对1.36±0.15 pg/ml，P<0.05）。除一名克兰费尔特综合征患者外，高渗盐水输注显示患者血管加压素反应存在不同程度的异常。5名患者对渗透压刺激的平均血管加压素反应（血浆血管加压素变化/血浆渗透压变化）低于正常受试者（0.04±0.01对0.16±0.02，P<0.05）。3名IHH患者和1名克兰费尔特综合征患者在脉冲式促性腺激素释放激素（GnRH）输注或庚酸睾酮肌肉注射后进行了复查。在用睾酮或GnRH治疗后，3名治疗前血管加压素反应异常的患者对高渗盐水输注的血浆血管加压素反应恢复正常（血浆血管加压素变化/血浆渗透压变化：0.04±0.01对0.09±0.01，P<0.05）。这些结果表明，睾酮可改善性腺功能减退男性对渗透压刺激的异常血管加压素反应。
