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甲状腺功能亢进和减退时血清促黄体生成素对促黄体生成素释放激素反应的研究(作者译)

[A study on serum luteinizing hormone response to luteinizing hormone-releasing hormone iny hyper- and hypothyroidism (author's transl)].

作者信息

Kojima T

出版信息

Nihon Naibunpi Gakkai Zasshi. 1976 Sep 20;52(9):926-41. doi: 10.1507/endocrine1927.52.9_926.

Abstract

In order to study the mechanism of gonadal dysfunction in patients with abnormal thyroid function, the pituitary luteinizing hormone (LH) response to 200 mug of luteinizing hormone-releasing hormone (LH-RH) was investigated in 20 untreated and 18 treated hyperthyroid patients and in 21 untreated and 8 treated hypothyroid patients in addition to 29 matched control subjects. Serum LH levels were measured by double-antibody radioimmunoassay technique with HLH kit Daiichi. In untreated hyperthyroid men, the slightly elevated mean basal level and the exaggerated mean response to LH-RH of LH were observed, and in treated hyperthyroid men, both values were found to be similar to those of matched control men. Furthermore, in these patients, the maximal increments and the net increments of responses to LH-RH of LH were correlated with serum thyroxine levels and Thyopac-3 values. In most untreated and treated hyperthyroid premenopausal women with and without menstrual disturbances, the basal levels and the responses to LH-RH of LH were similar to those of matched control premenopausal women. In untreated hyperthyroid postmenopausal women, the mean basal level of LH was elevated, although the mean LH response to LH-RH was similar to that of matched control postmenopausal women, and in treated hyperthyroid postmenopausal women, the mean basal level and the mean response to LH-RH of LH were similar to those of matched control postmenopausal women. Furthermore, in these patients, the basal levels were correlated with serum thyroxine levels. In untreated and treated hypothyroid men, the mean basal level and the mean response to LH-RH of LH were similar to those of untreated and treated hyperthyroid postmenopausal women. In most untreated and treated hypothyroid premenopausal women with and without menstrual disturbances, the basal levels were observed to be inconsistent, and the LH responses to LH-RH were similar to those of matched control premenopausal women. In untreated and treated hypothyroid postmenopausal women, the mean basal level and the mean response to LH-RH of LH were similar to those of matched control postmenopausal women. These data indicate that the ability of the pituitary to secrete LH in patients with abnormal thyroid function was augmented in hyper- and hypothyroid men, and augmented in hyper-, but normal in hypothyroid postmenopausal women. Therefore, it is concluded that the cause of gonadal dysfunction at least in the premenopausal women with abnormal thyroid function lies not inside but outside the pituitary gland.

摘要

为研究甲状腺功能异常患者性腺功能障碍的机制,对20例未经治疗和18例经治疗的甲状腺功能亢进患者、21例未经治疗和8例经治疗的甲状腺功能减退患者以及29例匹配的对照受试者,研究了垂体促黄体生成素(LH)对200μg促黄体生成素释放激素(LH-RH)的反应。采用第一制药HLH试剂盒,通过双抗体放射免疫分析技术测定血清LH水平。在未经治疗的甲状腺功能亢进男性中,观察到LH的平均基础水平略有升高,对LH-RH的平均反应增强;在经治疗的甲状腺功能亢进男性中,发现这两个值与匹配的对照男性相似。此外,在这些患者中,LH对LH-RH反应的最大增加值和净增加值与血清甲状腺素水平和Thyopac-3值相关。在大多数未经治疗和经治疗的甲状腺功能亢进绝经前女性中,无论有无月经紊乱,LH的基础水平和对LH-RH的反应与匹配的对照绝经前女性相似。在未经治疗的甲状腺功能亢进绝经后女性中,LH的平均基础水平升高,尽管LH对LH-RH的平均反应与匹配的对照绝经后女性相似;在经治疗的甲状腺功能亢进绝经后女性中,LH的平均基础水平和对LH-RH的平均反应与匹配的对照绝经后女性相似。此外,在这些患者中,基础水平与血清甲状腺素水平相关。在未经治疗和经治疗的甲状腺功能减退男性中,LH的平均基础水平和对LH-RH的平均反应与未经治疗和经治疗的甲状腺功能亢进绝经后女性相似。在大多数未经治疗和经治疗的甲状腺功能减退绝经前女性中,无论有无月经紊乱,基础水平不一致,LH对LH-RH的反应与匹配的对照绝经前女性相似。在未经治疗和经治疗的甲状腺功能减退绝经后女性中,LH的平均基础水平和对LH-RH的平均反应与匹配的对照绝经后女性相似。这些数据表明,甲状腺功能异常患者垂体分泌LH的能力在甲状腺功能亢进和减退男性中增强,在甲状腺功能亢进绝经后女性中增强,但在甲状腺功能减退绝经后女性中正常。因此,得出结论,至少在甲状腺功能异常的绝经前女性中,性腺功能障碍的原因不在垂体内部,而在垂体外部。

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