Malhotra A, Poon E, Tse W Y, Pringle P J, Hindmarsh P C, Brook C G
Endocrine Unit, Middlesex Hospital, London, UK.
Clin Endocrinol (Oxf). 1993 Apr;38(4):393-8. doi: 10.1111/j.1365-2265.1993.tb00520.x.
We studied the effects of oxandrolone on serum concentrations of LH, FSH, testosterone, GH, SHBG, DHEAS, IGF-I and insulin in boys with constitutional delay of growth and puberty.
Ten boys with constitutional delay of growth and puberty, mean age 13.8 years (range 12.4-15.5) were studied. Twenty-four-hour serum concentration profiles of GH, LH and FSH were constructed by drawing blood samples at 20-minute intervals. Three study occasions over a period of 6 months were chosen to assess hormone concentrations before, during and 6 weeks after a 3-month course of oxandrolone (2.5 mg once daily) therapy.
Growth velocity increased during oxandrolone treatment and stayed higher after therapy (pre 3.9 +/- 0.5; on 6.3 +/- 0.8; post 6.4 +/- 0.9 cm/year (mean +/- SEM) two way ANOVA, F = 5.3, P = 0.02). Oxandrolone had androgenic effects, suppressing mean serum LH concentrations from 1.7 +/- 0.3 to 1.1 +/- 0.2 U/I and serum testosterone concentrations from 1.9 +/- 0.6 to 0.8 +/- 0.1 nmol/l. SHBG concentrations were also reduced from 130.9 +/- 14.6 to 30.7 +/- 7.3 nmol/l. Serum GH concentration fell slightly from 5.9 +/- 0.6 to 4.8 +/- 0.5 mU/l. After cessation of treatment, there was a significant 'rebound' in mean 24-hour serum LH (2.6 U/l +/- 0.4) and testosterone concentrations (3.2 +/- 0.9 nmol/l) but no change in serum GH concentrations. SHBG values also rose but not to the same extent as those observed before therapy (82.0 +/- 8.4 nmol/l). There were no statistically significant differences in serum concentrations of FSH, DHEAS, IGF-I and insulin over the study period. In a stepwise multiple regression analysis of factors that might influence the growth rate observed, the 24-hour mean serum testosterone concentration and the treatment (on or off) with oxandrolone were the main influences. The relationship was described by the equation Height velocity = 0.69 (24-hour mean serum testosterone concentration)+1.70 (treatment regimen)+3.37 (adjusted R2 = 0.35, F = 8.39, P = 0.001).
Oxandrolone has an androgenic action as shown by changes in serum LH, testosterone and SHBG concentrations and by the lack of effect on FSH. No effect of oxandrolone on the GH axis was documented. We suggest that the growth promoting effects of oxandrolone are related in part to the mild androgenic effects of the steroid and the growth acceleration following oxandrolone withdrawal may reflect increasing total serum testosterone concentrations and decreasing levels of SHBG and progress in puberty.
我们研究了氧雄龙对体质性生长和青春期延迟男孩血清中促黄体生成素（LH）、促卵泡生成素（FSH）、睾酮、生长激素（GH）、性激素结合球蛋白（SHBG）、硫酸脱氢表雄酮（DHEAS）、胰岛素样生长因子-I（IGF-I）和胰岛素浓度的影响。
对10名体质性生长和青春期延迟的男孩进行研究，平均年龄13.8岁（范围12.4 - 15.5岁）。通过每隔20分钟采集血样构建GH、LH和FSH的24小时血清浓度曲线。在6个月的时间内选择三个研究时段，以评估在为期3个月的氧雄龙（每日2.5毫克，每日一次）治疗前、治疗期间和治疗后6周的激素浓度。
在氧雄龙治疗期间生长速度增加，治疗后仍保持较高水平（治疗前3.9±0.5；治疗中6.3±0.8；治疗后6.4±0.9厘米/年（均值±标准误），双向方差分析，F = 5.3，P = 0.02）。氧雄龙具有雄激素作用，使平均血清LH浓度从1.7±0.3降至1.1±0.2 U/I，血清睾酮浓度从1.9±0.6降至0.8±0.1 nmol/l。SHBG浓度也从130.9±14.6降至30.7±7.3 nmol/l。血清GH浓度从5.9±0.6略有下降至4.8±0.5 mU/l。治疗停止后，24小时平均血清LH（2.6 U/l±0.4）和睾酮浓度（3.2±0.9 nmol/l）出现显著“反弹”，但血清GH浓度无变化。SHBG值也有所上升，但未升至治疗前观察到的水平（82.0±8.4 nmol/l）。在研究期间，血清FSH、DHEAS、IGF-I和胰岛素浓度无统计学显著差异。在对可能影响观察到的生长速率的因素进行逐步多元回归分析中，24小时平均血清睾酮浓度和氧雄龙治疗（治疗中或治疗后）是主要影响因素。这种关系由方程身高速度 = 0.69（24小时平均血清睾酮浓度）+1.70（治疗方案）+3.37（调整后R² = 0.35，F = 8.39，P = 0.001）描述。
如血清LH、睾酮和SHBG浓度的变化以及对FSH无影响所示，氧雄龙具有雄激素作用。未记录到氧雄龙对GH轴有影响。我们认为氧雄龙的促生长作用部分与该类固醇的轻度雄激素作用有关，氧雄龙停药后生长加速可能反映血清总睾酮浓度增加、SHBG水平降低以及青春期进展。
