Bagatell C J, Dahl K D, Bremner W J
Medical Service, Seattle Veterans Affairs Medical Center, Washington.
J Androl. 1994 Jan-Feb;15(1):15-21.
In men, administration of exogenous testosterone (T) exerts direct negative feedback effects at the pituitary as well as at the hypothalamic level. This study was undertaken to determine whether T itself causes the inhibitory effects on the pituitary, or whether conversion to estradiol (E2) or dihydrotestosterone (DHT) is required. We assessed the biological activity of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH), as well as immunoactivity. Blood samples were drawn before, during, and after a continuous, 72-hour i.v. infusion of T (15 mg/day), E2 (90 micrograms/day), or DHT (500 micrograms/day). Each of these doses is twice the daily production rate of the steroid. Each man received each of the three steroid infusions. We studied four men, ages 23-35, with idiopathic hypothalamic hypogonadism (IHH), who were treated with pulsatile gonadotropin releasing hormone (GnRH) until their gonadotropins reached the normal range. Serum levels of T, E2, DHT, and levels of immunologically active and biologically active LH and FSH were measured. We found that administration of each steroid increased serum levels of the infused steroid to the upper physiologic range. Administration of T or E2 resulted in decreased mean levels of biologically and immunologically active LH and FSH; administration of DHT did not alter gonadotropin secretion. These data suggest that some of the direct effect of T at the pituitary level in men is mediated by E2, whereas peripherally formed DHT may not play an important role in this process.
在男性中,外源性睾酮(T)的给药在垂体以及下丘脑水平发挥直接的负反馈作用。本研究旨在确定是T本身对垂体产生抑制作用,还是需要转化为雌二醇(E2)或双氢睾酮(DHT)。我们评估了血清促黄体生成素(LH)和促卵泡生成素(FSH)的生物活性以及免疫活性。在连续72小时静脉输注T(15毫克/天)、E2(90微克/天)或DHT(500微克/天)之前、期间和之后采集血样。这些剂量中的每一种都是该类固醇每日产生速率的两倍。每个男性接受这三种类固醇输注中的每一种。我们研究了四名年龄在23 - 35岁之间的特发性下丘脑性腺功能减退(IHH)男性,他们接受脉冲式促性腺激素释放激素(GnRH)治疗,直到其促性腺激素达到正常范围。测量了血清T、E2、DHT水平以及免疫活性和生物活性LH及FSH的水平。我们发现,每种类固醇的给药都会使输注类固醇的血清水平升高至生理上限范围。T或E2的给药导致生物活性和免疫活性LH及FSH的平均水平降低;DHT的给药未改变促性腺激素的分泌。这些数据表明,男性中T在垂体水平的一些直接作用是由E2介导的,而外周形成的DHT在这一过程中可能不发挥重要作用。