Castelo-Branco C, Martínez de Osaba M J, Martínez S, Fortuny A
Department of Gynaecology and Obstetrics, Hospital Clínic i Provincial, University of Barcelona Medical School, Spain.
Metabolism. 1996 Jan;45(1):24-7. doi: 10.1016/s0026-0495(96)90195-x.
We evaluated modifications in the pituitary-ovarian-adrenal axis in severely hirsute women after administration of the gonadotropin-releasing hormone analog (GnRHa), D-Trp-6-luteinizing hormone-releasing hormone (LHRH) (Triptorelin) in a prospective study at a tertiary hospital. A total of 20 hirsute women aged 19 to 38 years were included. Hyperandrogenism of adrenal origin was excluded in all subjects. Patients received 3.75 mg D-Trp-6-LHRH intramuscularly (Decapeptyl 3.75; Lasa-Ipsen, Barcelona, Spain). Serum levels of follicle-stimulating hormone (FSH), LH, estradiol (E2), prolactin (PRL), testosterone (T), androstenedione (delta 4 An), dehydroepiandrosterone sulfate (DHEAS), 17-OH-progesterone (17-OHP), and sex hormone-binding globulin (SHBG) were determined before GnRHa administration, 24 and 48 hours after, and on days 7, 15, 30, and 45. GnRHa suppresses FSH, LH, and E2 in all women. Unexpectedly, adrenal steroids showed a flare-up phenomenon in the first days and subsequent decrease to lower values than before GnRHa administration. SHBG showed slight changes. After GnRHa, patients showed a significant decrease in T and delta 4 An: these hormones were reduced to half the basal levels. We conclude that GnRHa can potentially be used in the treatment of hyperandrogenism to reduce androgen levels in hirsute women.
在一家三级医院进行的一项前瞻性研究中，我们评估了促性腺激素释放激素类似物（GnRHa）、D-色氨酸-6-促黄体生成素释放激素（LHRH）（曲普瑞林）给药后，重度多毛女性垂体-卵巢-肾上腺轴的变化。共纳入20名年龄在19至38岁的多毛女性。所有受试者均排除肾上腺源性高雄激素血症。患者肌肉注射3.75mg D-色氨酸-6-LHRH（曲普瑞林3.75；Lasa-Ipsen，巴塞罗那，西班牙）。在GnRHa给药前、给药后24小时和48小时以及第7、15、30和45天测定血清促卵泡生成素（FSH）、促黄体生成素（LH）、雌二醇（E2）、催乳素（PRL）、睾酮（T）、雄烯二酮（δ4 An）、硫酸脱氢表雄酮（DHEAS）、17-羟孕酮（17-OHP）和性激素结合球蛋白（SHBG）水平。GnRHa可抑制所有女性的FSH、LH和E2。出乎意料的是，肾上腺类固醇在开始几天出现激增现象，随后降至低于GnRHa给药前的值。SHBG变化轻微。GnRHa给药后，患者的T和δ4 An显著降低：这些激素降至基础水平的一半。我们得出结论，GnRHa可能可用于治疗高雄激素血症，以降低多毛女性的雄激素水平。
