Vigersky R A, Loriaux D L, Andersen A E, Mecklenburg R S, Vaitukaitis J L
J Clin Endocrinol Metab. 1976 Oct;43(4):893-900. doi: 10.1210/jcem-43-4-893.
The qualitative and quantitative responses of LRF-induced LH and FSH release and TRF-induced TSH and Prolactin (PRL) release were evaluated in 21 patients with anorexia nervosa, 19 patients with secondary amenorrhea associated with simple weight loss (SWL) who did not fulfill the psychologic criteria for anorexia nervosa, and 7 normal women in the early follicular phase of the menstrual cycle. Basal plasma LH and FSH were significantly lower in the anorexia nervosa group compared to the SWL group and normals (P less than 0.05). The LRF-induced integrated LH responses, however, were the same in the 3 groups and the integrated FSH responses were greater in the underweight groups when compared to normal. The time of the peak LH response (mean+/-SE) was signifantly delayed (P less than 0.01) in both the anorexia nervosa (49 +/- 6.1 min) and SWL (28 +/- 2.5 min) groups when compared to normal (17 +/- 2.3 min). The time of the FSH response was significantly delayed (P less than 0.05) in anorexia nervosa (95 +/- 9.6 min) when compared to normals (35 +/0 7.9 min) and SWL patients (62 +/- 11.7 min). Normal basal TSH and PRL and normal peak TSH and PRL responses to TRF were found in anorexia nervosa. The time of the TSH and PRL peak (56+/-8.9 and 36+/-3.6 min,, respectively) in anorexia nervosa was significantly later than normal (26 +/- 1.7 and 36 +/- 3.6 min respectively) (P less than 0.01). It is concluded that despite normal quantitative response to releasing hormones, there are abnormally delayed responses in both anorexia nervosa and SWL patients. The SWL responses were intermediate between those of the anorexia nervosa group and normals. The constellation of normal quantitative but abnormal kinetic LRF and TRF responses supports the hypothesis that the endocrine changes seen in anorexia nervosa are consistent with hypothalamic dysfunction.
对21例神经性厌食症患者、19例因单纯体重减轻（SWL）导致继发性闭经且不符合神经性厌食症心理标准的患者以及7例处于月经周期卵泡早期的正常女性，评估了促性腺激素释放激素（LRF）诱导的促黄体生成素（LH）和促卵泡生成素（FSH）释放以及促甲状腺激素释放激素（TRF）诱导的促甲状腺激素（TSH）和催乳素（PRL）释放的定性和定量反应。与SWL组和正常组相比，神经性厌食症组的基础血浆LH和FSH显著降低（P<0.05）。然而，LRF诱导的LH综合反应在三组中相同，与正常组相比，体重不足组的FSH综合反应更大。与正常组（17±2.3分钟）相比，神经性厌食症组（49±6.1分钟）和SWL组（28±2.5分钟）的LH反应峰值时间显著延迟（P<0.01）。与正常组（35±7.9分钟）和SWL患者（62±11.7分钟）相比，神经性厌食症组（95±9.6分钟）的FSH反应时间显著延迟（P<0.05）。在神经性厌食症患者中发现基础TSH和PRL以及TRF刺激后的TSH和PRL峰值反应正常。神经性厌食症患者的TSH和PRL峰值时间（分别为56±8.9分钟和36±3.6分钟）显著晚于正常组（分别为26±1.7分钟和36±3.6分钟）（P<0.01）。结论是，尽管对释放激素的定量反应正常，但神经性厌食症患者和SWL患者的反应均异常延迟。SWL患者的反应介于神经性厌食症组和正常组之间。正常定量但异常动力学的LRF和TRF反应支持了以下假设，即神经性厌食症中所见的内分泌变化与下丘脑功能障碍一致。
