Travaglini P, Beck-Peccoz P, Ferrari C, Ambrosi B, Paracchi A, Severgnini A, Spada A, Faglia G
Acta Endocrinol (Copenh). 1976 Feb;81(2):252-62. doi: 10.1530/acta.0.0810252.
The secretion of lutenizing hormone (LH), follicle-stimulating hormone (FSH), thyrotrophin (TSH) and prolactin (PRL, was studied in 17 women suffering from anorexia nervosa. The mean basal serum LH was reduced (8.4 +/- 0.8 SE mIU/ml; P less than 0.001 vs normal controls), while LH increase after gonadotrophin-releasing hormone (LH-RH) appeared to be normal in 9 cases and impaired in 6 cases. The mean basal FSH did not significantly differ from normal subjects (3.9 +/- 0.5 mIU/ml), while LH-RH administration elicited an exaggerated increase in 7 cases and a normal increase in 8 cases: the mean FSH response was significantly higher than in controls (P less than 0.02). Plasma oestradiol-17beta was reduced (20.4 +/- 0.4 pg/ml; P less than 0.001) while the serum testosterone levels were normal (0.73 +/- 0.09 ng/ml). Clomiphene administration induced an increase in gonadotrophins in only 1 out of 7 patients. The mean serum TSH concentration was normal (2.3 +/- 0.4 muU/ml), while serum thyroxine and triiodothyronine and free thyroxine index, thought generally in the normal range, were significantly lower than values obtained in a control group (6.1 +/- 0.4 mug/100 ml, P less than 0.005; 102.3 +/- 7.7 ng/100 ml, P less than 0.005; 3.8 +/- 0.3, P less than 0.05). Though the mean serum TSH increase after thyrotrophin-releasing hormone (TRH) was normal (12.0 +/- 2.3 muU/ml), there were 4 impaired and 1 exaggerated increases, and 8 patients showed a delayed and frequently prolonged response. The increase in serum T3 after TRH appeared lower than in normal subjects (36.3 +/- 1.8 ng/100 ml, P less than 0.001). Serum PRL levels in basal conditions were higher than in the controls (19.4 +/- 4.1 ng/ml, P less than 0.001) while the increase in PRL after TRH was exaggerated in only 2 patients. The present data suggest that the primary failure in gonadotrophin secretion in anorexia nervosa occurs at hypothalamic level; moreover the data on TSH and PRL secretion also point to the existence of a hypothalamic disorder in this disease.
对17名神经性厌食症女性患者的促黄体生成素（LH）、促卵泡生成素（FSH）、促甲状腺激素（TSH）和催乳素（PRL）分泌情况进行了研究。基础血清LH均值降低（8.4±0.8SE mIU/ml；与正常对照组相比，P<0.001），而促性腺激素释放激素（LH-RH）刺激后，9例患者的LH升高似乎正常，6例患者受损。基础FSH均值与正常受试者无显著差异（3.9±0.5 mIU/ml），但注射LH-RH后，7例患者出现过度升高，8例患者升高正常：FSH平均反应显著高于对照组（P<0.02）。血浆雌二醇-17β降低（20.4±0.4 pg/ml；P<0.001），而血清睾酮水平正常（0.73±0.09 ng/ml）。7例患者中仅1例服用克罗米芬后促性腺激素升高。血清TSH平均浓度正常（2.3±0.4 μU/ml），而血清甲状腺素、三碘甲状腺原氨酸和游离甲状腺素指数虽总体在正常范围内，但显著低于对照组（分别为6.1±0.4 μg/100 ml，P<0.005；102.3±7.7 ng/100 ml，P<0.005；3.8±0.3，P<0.05）。虽然促甲状腺激素释放激素（TRH）刺激后血清TSH平均升高正常（12.0±2.3 μU/ml），但有4例升高受损，1例过度升高，8例患者反应延迟且常常延长。TRH刺激后血清T3升高低于正常受试者（36.3±1.8 ng/100 ml，P<0.001）。基础状态下血清PRL水平高于对照组（19.4±4.1 ng/ml，P<0.001），但TRH刺激后仅2例患者PRL升高过度。目前的数据表明，神经性厌食症患者促性腺激素分泌的原发性缺陷发生在下丘脑水平；此外，关于TSH和PRL分泌的数据也表明该疾病存在下丘脑功能障碍。
