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通过促黄体生成素β亚基对促甲状腺激素释放激素的反应来鉴定临床无功能腺瘤男性患者中的促性腺激素腺瘤。

Identification of gonadotroph adenomas in men with clinically nonfunctioning adenomas by the luteinizing hormone beta subunit response to thyrotropin-releasing hormone.

作者信息

Daneshdoost L, Gennarelli T A, Bashey H M, Savino P J, Sergott R C, Bosley T M, Snyder P J

机构信息

Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.

出版信息

J Clin Endocrinol Metab. 1993 Nov;77(5):1352-5. doi: 10.1210/jcem.77.5.8077332.

Abstract

Because of the recent finding that a majority of clinically nonfunctioning pituitary macroadenomas in women could be identified as of gonadotroph origin by their LH beta-subunit responses to TRH, we evaluated in this study the value of the LH beta-subunit response to TRH in identifying gonadotroph adenomas in men with clinically nonfunctioning macroadenomas. Thirty-eight consecutively studied men with clinically nonfunctioning macroadenomas were given TRH iv, and intact FSH and LH and LH beta- and alpha-subunits were measured every 15 min for 90 min before and 90 min after. TRH tests were also performed on 15 healthy, age-matched control men and on 12 men with adenomas secreting GH or PRL. Of the 38 men with clinically nonfunctioning macroadenomas, basal values were supranormal in 10 for FSH and in 6 each for alpha- and LH beta-subunits. Responses to TRH were elevated, compared to the healthy, age-matched controls, in 14 for LH beta-subunit and in 5 each for intact FSH and LH. None of the men with adenomas secreting GH or PRL exhibited supranormal responses to TRH. Of the 38 clinically nonfunctioning adenomas, 35 were established in dispersed cell culture, and 29 secreted readily detectable amounts of intact FSH, LH, and LH beta-subunit, strongly suggesting that these adenomas were of gonadotroph cell origin. We conclude that the LH beta-subunit response to TRH can identify gonadotroph adenomas in men with clinically nonfunctioning adenomas better than can basal concentrations of intact FSH and alpha-subunit, alone or combined, but not as well as it can in women.

摘要

由于最近发现,通过促黄体生成素(LH)β亚基对促甲状腺激素释放激素(TRH)的反应,大多数临床上无功能的女性垂体大腺瘤可被确定为促性腺激素细胞起源,因此我们在本研究中评估了LHβ亚基对TRH的反应在识别患有临床上无功能大腺瘤的男性促性腺激素细胞腺瘤中的价值。连续研究了38名患有临床上无功能大腺瘤的男性,静脉注射TRH,在注射前90分钟和注射后90分钟内,每隔15分钟测量一次完整的促卵泡生成素(FSH)、LH以及LHβ和α亚基。还对15名年龄匹配的健康对照男性和12名分泌生长激素(GH)或催乳素(PRL)的腺瘤男性进行了TRH测试。在38名患有临床上无功能大腺瘤的男性中,FSH的基础值在10例中高于正常,α亚基和LHβ亚基的基础值在6例中高于正常。与年龄匹配的健康对照相比,LHβ亚基对TRH的反应在14例中升高,完整的FSH和LH在5例中升高。分泌GH或PRL的腺瘤男性对TRH均未表现出高于正常的反应。在38例临床上无功能的腺瘤中,35例在分散细胞培养中得以确定,29例分泌出易于检测到的完整FSH、LH和LHβ亚基,强烈提示这些腺瘤起源于促性腺激素细胞。我们得出结论,LHβ亚基对TRH的反应在识别患有临床上无功能腺瘤的男性促性腺激素细胞腺瘤方面,比单独或联合使用完整FSH和α亚基的基础浓度更好,但不如在女性中那样有效。

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