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夜间注射纳洛酮无法逆转睾酮输注对青春期男孩促黄体生成素分泌的抑制作用。

Nocturnal naloxone fails to reverse the suppressive effects of testosterone infusion on luteinizing hormone secretion in pubertal boys.

作者信息

Kletter G B, Foster C M, Brown M B, Beitins I Z, Marshall J C, Kelch R P

机构信息

Department of Pediatrics, University of Michigan, Ann Arbor 48109.

出版信息

J Clin Endocrinol Metab. 1994 Oct;79(4):1147-51. doi: 10.1210/jcem.79.4.7962287.

Abstract

LH secretion is maximal during the night in pubertal boys, and testosterone (T) administration blunts this nocturnal rise of LH. We have previously shown that in pubertal boys, the acute negative feedback effects of T infusion on LH secretion during the daytime cannot be reversed by opioid receptor blockade. To determine whether the nocturnal secretion of LH in early puberty is regulated by endogenous opioid pathways, we determined whether naloxone during the night affected LH secretion or T-mediated suppression of LH secretion. Seven pubertal boys (bone age, 11-13.5 yr) were given a control infusion of saline, followed 1 week later by an infusion of T at 960 nmol/m2.h for 41 h starting at 2000 h. During both saline and T infusions, six iv boluses of saline were given hourly beginning at 2400 h on the first day, and six iv boluses of naloxone (0.1 mg/kg each) were given hourly beginning at 2400 h on the second day. Starting at 2200 h, blood was obtained every 15 min for LH and every 30 min for T determinations for 14 h each night. Pituitary responsiveness was assessed at the end of each study night by i.v. bolus administration of 250 ng/kg synthetic GnRH. T infusion increased the mean T concentration 6-fold (P < 0.0001) and suppressed the mean plasma LH concentrations from 5.6 +/- 0.6 to 3.8 +/- 0.6 IU/L (P < 0.01). The nocturnal augmentation of LH secretion was suppressed by the infusion of T, and this suppression was not reversed by naloxone. The mean nighttime plasma LH (2400-0600 h) was 8.1 +/- 1.1 IU/L during the control saline infusion and 5.1 +/- 0.6 IU/L during the T infusion (P < 0.01). The mean LH level was 4.0 +/- 0.7 IU/L during the administration of naloxone boluses concomitantly with the T infusion, not significantly different from that during the T infusion. Likewise, LH pulse frequency during the same time period was decreased by T infusion from 0.6 +/- 0.1 to 0.36 +/- 0.04 pulses/boy.h (P < 0.05), and it was unaltered by coadministration of naloxone (0.38 +/- 0.12 pulses/boy.h). Naloxone administration during the saline infusion did not increase either the mean plasma LH concentration (7.5 +/- 0.7 IU/L; P = NS vs. saline control) or the LH pulse frequency (0.69 +/- 0.1 pulses/boy.h; P = NS vs. saline control). Pituitary responsiveness to GnRH was similar on each of the 4 nights during either saline or T infusions.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

在青春期男孩中,促黄体生成素(LH)的分泌在夜间达到最大值,而给予睾酮(T)会抑制LH的夜间升高。我们之前已经表明,在青春期男孩中,白天T输注对LH分泌的急性负反馈作用不能通过阿片受体阻断来逆转。为了确定青春期早期LH的夜间分泌是否受内源性阿片途径调节,我们研究了夜间给予纳洛酮是否会影响LH分泌或T介导的LH分泌抑制。7名青春期男孩(骨龄11 - 13.5岁)先接受生理盐水对照输注,1周后从20:00开始以960 nmol/m²·h的速度输注T,持续41小时。在生理盐水和T输注期间,第一天从24:00开始每小时静脉推注6次生理盐水,第二天从24:00开始每小时静脉推注6次纳洛酮(每次0.1 mg/kg)。从22:00开始,每晚每15分钟采集一次血样测定LH,每30分钟采集一次血样测定T,共14小时。在每个研究夜晚结束时,通过静脉推注250 ng/kg合成促性腺激素释放激素(GnRH)来评估垂体反应性。T输注使平均T浓度增加了6倍(P < 0.0001),并将平均血浆LH浓度从5.6±0.6降至3.8±0.6 IU/L(P < 0.01)。T输注抑制了LH分泌的夜间增加,且这种抑制未被纳洛酮逆转。对照生理盐水输注期间夜间血浆LH(24:00 - 06:00 h)平均为8.1±1.1 IU/L,T输注期间为5.1±0.6 IU/L(P < 0.01)。在与T输注同时给予纳洛酮推注期间,平均LH水平为4.0±0.7 IU/L,与T输注期间无显著差异。同样,同一时间段内LH脉冲频率因T输注从0.6±0.1降至0.36±0.04次/男孩·小时(P < 0.05),联合给予纳洛酮后未改变(0.38±0.12次/男孩·小时)。生理盐水输注期间给予纳洛酮既未增加平均血浆LH浓度(7.5±0.7 IU/L;与生理盐水对照相比P = 无显著性差异),也未增加LH脉冲频率(0.69±0.1次/男孩·小时;与生理盐水对照相比P = 无显著性差异)。在生理盐水或T输注期间的4个夜晚中,垂体对GnRH 的反应性相似。(摘要截断于400字)

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