Reyes-Fuentes A, Chavarría M E, Carrera A, Aguilera G, Rosado A, Samojlik E, Iranmanesh A, Veldhuis J D
División de Investigación Biomédica, Instituto Nacional de Perinatología, Mexico D.F., Mexico.
J Clin Endocrinol Metab. 1996 Feb;81(2):524-9. doi: 10.1210/jcem.81.2.8636262.
To investigate the nature of neuroendocrine disturbances of the hypothalamo-pituitary-gonadal axis in idiopathic male infertility, we studied 14 infertile men with oligoasthenozoospermia (OLIGO) and 15 age-, body mass index-, and community-matched euspermic controls by blood withdrawal at 10-min intervals for 12 h to encompass basal (8-h) and exogenous GnRH-stimulated (4-h) pulsatile release of LH and FSH (by immunoradiometric assay) as well as testosterone (by RIA). Deconvolution analysis was used to estimate endogenous LH and FSH half-lives, secretory burst frequency, amplitude, duration, and mass. OLIGO men exhibited normal serum concentrations of total, free, and percent dialyzable testosterone and estradiol, but distinct dynamic alterations within the LH and FSH axes; namely (P < 0.05), 1) a prolonged half-life of LH (OLIGO, 95 +/- 19 min; control, 80 +/- 9.3 min) and a reduced half-life of FSH (OLIGO, 260 +/- 79 min; control, 320 +/- 93 min); 2) a low LH, but normal FSH, secretory burst frequency (OLIGO, 12 +/- 3.4; control, 15 +/- 3.0 LH pulses/day); 3) a decreased serum testosterone peak frequency (OLIGO, 16 +/- 4.3; control, 21 +/- 3.2 peaks/day); and 4) an amplified mass of LH (1.1- to 1.3-fold higher in OLIGO) and FSH (2.4- to 2.7-fold higher in OLIGO) secreted per burst basally as well as after GnRH injection. These disturbances were readily distinguishable from the neuroendocrine dysregulation described in other states of male hypogonadotropism (e.g. uremia, fasting, and aging).
为研究特发性男性不育症患者下丘脑 - 垂体 - 性腺轴神经内分泌紊乱的性质,我们对14例少弱精子症(OLIGO)不育男性及15例年龄、体重指数和社区匹配的正常精子对照者进行了研究。每隔10分钟采血一次,共12小时,以涵盖基础状态(8小时)和外源性促性腺激素释放激素(GnRH)刺激状态(4小时)下促黄体生成素(LH)和促卵泡生成素(FSH)的脉冲式释放(通过免疫放射分析法)以及睾酮(通过放射免疫分析法)。采用反卷积分析法估算内源性LH和FSH的半衰期、分泌脉冲频率、幅度、持续时间和总量。OLIGO组男性血清总睾酮、游离睾酮及可透析睾酮百分比和雌二醇浓度正常,但LH和FSH轴存在明显的动态改变;具体如下(P < 0.05):1)LH半衰期延长(OLIGO组,95 ± 19分钟;对照组,80 ± 9.3分钟),FSH半衰期缩短(OLIGO组,260 ± 79分钟;对照组,320 ± 93分钟);2)LH分泌脉冲频率低,但FSH正常(OLIGO组,12 ± 3.4;对照组,15 ± 3.0次LH脉冲/天);3)血清睾酮峰值频率降低(OLIGO组,16 ± 4.3;对照组,21 ± 3.2次峰值/天);4)基础状态及GnRH注射后每次脉冲分泌的LH总量(OLIGO组高1.1至1.3倍)和FSH总量(OLIGO组高2.4至2.7倍)增加。这些紊乱与其他男性性腺功能减退状态(如尿毒症、禁食和衰老)所描述的神经内分泌失调易于区分。