Wilson L D, Truong M P, Barber A R, Aoki T T
Department of Medicine, University of California, Davis, USA.
Metabolism. 1996 Jun;45(6):738-46. doi: 10.1016/s0026-0495(96)90140-7.
To evaluate pituitary and pituitary-dependent target organ function in men infected with the human immunodeficiency virus (HIV), 26 ambulatory HIV-positive men (13 with acquired immunodeficiency syndrome [AIDS]) and nine healthy control men were administered rapid sequential injections of thyrotropin (TSH)-releasing hormone (TRH), gonadotropin-releasing hormone (GnRH), ovine corticotropin (ACTH)-releasing hormone (oCRH), and human growth hormone-(GH)-releasing hormone (hGHRH). Blood samples were collected before and for 90 minutes after the injections for immunoassay of pituitary hormones, cortisol, testosterone, and free thyroxine (fT(4)). Data were analyzed for each group of men considering basal, peak, and incremental responses to the releasing hormones, as well as the time course of response of each hormone. Mean basal serum GH concentrations were the same in all groups (control, AIDS, and non-AIDS HIV-positive), but stimulated GH levels were substantially higher at all time points in both groups of HIV-positive subjects. Results for prolactin (PRL) were similar, although stimulated PRL levels were increased significantly only in the AIDS group. The mean basal serum TSH concentration and stimulated TSH levels at 60 and 90 minutes were significantly greater in the AIDS group than in the control group. Basal mean fT(4) concentration in the AIDS group was significantly less than in the control group. Mean basal and stimulated serum (total) testosterone concentrations in all groups were the same. However, basal serum luteinizing hormone (LH) concentrations in both groups of HIV-infected men were significantly greater than in controls; stimulated (peak) LH levels were not different from control levels. Basal and peak stimulated plasma ACTH concentrations were significantly increased in both HIV-infected groups. Basal serum cortisol levels were also greater, on average, in HIV-infected groups, although stimulated (peak) cortisol responses were not different. These results indicate that basal serum concentrations of TSH, LH, ACTH, and cortisol are modestly increased in men with AIDS, and that maximum levels of GH, PRL, TSH, and ACTH stimulated by the releasing hormones are also increased in this group. Measurements obtained in the non-AIDS HIV-infected men showed a pattern generally similar to that obtained in men with AIDS, but less marked. The basis for the increased pituitary activity is unknown; we speculate that it is due to modestly impaired target organ function and to increased hypothalamic stimulation.
为评估感染人类免疫缺陷病毒（HIV）男性的垂体及垂体依赖靶器官功能，对26名非卧床HIV阳性男性（其中13名患有获得性免疫缺陷综合征[AIDS]）和9名健康对照男性快速序贯注射促甲状腺激素（TSH）释放激素（TRH）、促性腺激素释放激素（GnRH）、羊促肾上腺皮质激素（ACTH）释放激素（oCRH）和人生长激素（GH）释放激素（hGHRH）。在注射前及注射后90分钟采集血样，用于垂体激素、皮质醇、睾酮和游离甲状腺素（fT₄）的免疫测定。分析每组男性的数据，考虑释放激素的基础、峰值和增量反应，以及每种激素的反应时间过程。所有组（对照组、AIDS组和非AIDS HIV阳性组）的基础血清GH浓度相同，但两组HIV阳性受试者在所有时间点的刺激后GH水平均显著更高。催乳素（PRL）的结果相似，尽管仅AIDS组的刺激后PRL水平显著升高。AIDS组的基础血清TSH浓度以及6０和90分钟时的刺激后TSH水平显著高于对照组。AIDS组的基础平均fT₄浓度显著低于对照组。所有组的基础和刺激后血清（总）睾酮浓度相同。然而，两组HIV感染男性的基础血清黄体生成素（LH）浓度显著高于对照组；刺激后（峰值）LH水平与对照组无差异。两组HIV感染组的基础和峰值刺激后血浆ACTH浓度均显著升高。HIV感染组的基础血清皮质醇水平平均也更高，尽管刺激后（峰值）皮质醇反应无差异。这些结果表明，AIDS男性的基础血清TSH、LH、ACTH和皮质醇浓度适度升高，且该组中释放激素刺激后的GH、PRL、TSH和ACTH的最高水平也升高。在非AIDS HIV感染男性中获得的测量结果显示出与AIDS男性通常相似的模式，但不太明显。垂体活动增加的原因尚不清楚；我们推测这是由于靶器官功能适度受损以及下丘脑刺激增加所致。
