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女孩青春期过渡期间促性腺激素释放激素脉冲发生器的活性:循环促性腺激素的脉冲式和昼夜模式

Gonadotropin-releasing hormone pulse generator activity during pubertal transition in girls: pulsatile and diurnal patterns of circulating gonadotropins.

作者信息

Apter D, Bützow T L, Laughlin G A, Yen S S

机构信息

Department of Reproductive Medicine, School of Medicine, University of California San Diego, La Jolla 92093-0802.

出版信息

J Clin Endocrinol Metab. 1993 Apr;76(4):940-9. doi: 10.1210/jcem.76.4.8473410.

Abstract

To delineate the activity of the GnRH pulse generator during pubertal transition, 40 healthy girls 7-18 yr of age were studied. Ten were prepubertal (PP), 7 were in early puberty (EP), and 23 were in late puberty (LP, all postmenarcheal). Serum concentrations of LH and FSH were measured with immunofluorometric assays, which have a sensitivity about 100-fold that of RIA, in samples taken at 10-min intervals for 24 h during basal conditions, during Nal-Glu antagonist suppression, and in response to GnRH stimulation (10 micrograms). Serum levels of androstenedione, testosterone, and estradiol were measured with RIA. A pulsatile pattern of LH and FSH secretion was found in girls of all ages. PP girls had irregular LH pulses with low amplitudes during the daytime, but increased amplitude LH and FSH pulses were evident within 1 h after sleep-onset. Older PP girls had more regular and higher amplitude pulses throughout sleep than younger PP girls. The sleep-related LH and FSH pulses in PP girls were abolished with Nal-Glu GnRH antagonist treatment, reflecting endogenous GnRH pulse activities. The PP group had the most pronounced amplification of LH secretion with sleep yielding a sleep-wake ratio of 4, which decreased to 2 in the EP group and to 1 in the LP group. The emergence of regular daytime LH pulses along with a further amplification of pulsatile activity during sleep was closely related to the onset of breast development. By the age of 16 yr, an LH secretory pattern characteristic of adult women in the early follicular phase, i.e. a decrease in LH concentration during sleep, was established. Mean 24-h LH concentrations increased 40-fold from PP to LP consequent to a 9-fold increase in pulse amplitude and a 4-fold increase in pulse number (both P < 0.0001). Mean FSH concentrations (24 h), which were 20-fold higher than corresponding LH concentrations in the PP group, increased only 3-fold from the PP to the LP group. FSH pulse secretion appears to be predominantly GnRH dependent in PP girls in contrast to girls after ovarian activation, as indicated by the increased FSH responses to both GnRH antagonist suppression and GnRH stimulation in the PP as compared to the EP and LP groups. We conclude that the GnRH pulse generator is functionally active in prepubertal girls with selective expression of LH and FSH pulses after the onset of sleep. The onset of puberty is associated with a greater increase in LH pulse amplitude than frequency.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

为了描绘青春期过渡期间促性腺激素释放激素(GnRH)脉冲发生器的活性,对40名7至18岁的健康女孩进行了研究。其中10名处于青春期前(PP),7名处于青春期早期(EP),23名处于青春期后期(LP,均已月经初潮)。在基础状态下、使用那格列奈-谷氨酸拮抗剂抑制期间以及对GnRH刺激(10微克)作出反应时,每隔10分钟采集一次样本,用免疫荧光测定法测量血清促黄体生成素(LH)和促卵泡生成素(FSH)浓度,该方法的灵敏度约为放射免疫分析(RIA)的100倍。用RIA测量血清雄烯二酮、睾酮和雌二醇水平。在所有年龄段的女孩中均发现了LH和FSH分泌的脉冲模式。PP组女孩白天的LH脉冲不规则且幅度低,但入睡后1小时内LH和FSH脉冲幅度增加明显。年龄较大的PP组女孩在整个睡眠期间的脉冲比年龄较小的PP组女孩更规律、幅度更高。PP组女孩与睡眠相关的LH和FSH脉冲在接受那格列奈-谷氨酸GnRH拮抗剂治疗后消失,反映了内源性GnRH脉冲活动。PP组睡眠时LH分泌的放大最为明显,睡眠-觉醒比为4,EP组降至2,LP组降至1。白天规律的LH脉冲的出现以及睡眠期间脉冲活动的进一步放大与乳房发育的开始密切相关。到16岁时,建立了成年女性卵泡早期特征性的LH分泌模式,即睡眠期间LH浓度降低。从PP组到LP组,24小时平均LH浓度增加了40倍,这是由于脉冲幅度增加了9倍和脉冲数量增加了4倍(均P<0.0001)。PP组平均FSH浓度(24小时)比相应的LH浓度高20倍,从PP组到LP组仅增加了3倍。与EP组和LP组相比,PP组女孩对GnRH拮抗剂抑制和GnRH刺激的FSH反应增加,这表明与卵巢激活后的女孩相比,PP组女孩的FSH脉冲分泌似乎主要依赖于GnRH。我们得出结论,GnRH脉冲发生器在青春期前女孩中功能活跃,睡眠开始后LH和FSH脉冲有选择性表达。青春期的开始与LH脉冲幅度的增加比频率的增加更大有关。(摘要截短至400字)

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