Korzekwa M I, Lamont J A, Steiner M
Women's Health Concerns Clinic, McMaster Psychiatric Unit, St. Joseph's Hospital, Hamilton, Ontario, Canada.
J Clin Endocrinol Metab. 1996 Jun;81(6):2280-4. doi: 10.1210/jcem.81.6.8964864.
Late luteal phase dysphoric disorder (LLPDD), also known as premenstrual dysphoria, has been etiologically linked to both depression and thyroid disease. We examined baseline and TRH-stimulated thyroid function in 45 otherwise healthy women with prospectively confirmed LLPDD during the follicular and luteal phases of their menstrual cycles. The means of all thyroid variables were normal. Three (6.8%) subjects had elevated baseline TSH (mild hypothyroidism), and 6 (13.3%) had an exaggerated TSH response (delta max TSH) to TRH (subclinical hypothyroidism). A blunted delta max TSH (< 5 mU/L) was found in only 4.4% of the subjects. History of a past major psychiatric diagnosis (mostly depression) or a current personality disorder correlated with a lower delta max TSH. As baseline TSH, using the new ultrasensitive radioimmunometric assay, correlated strongly with delta max TSH, the utility of the TRH challenge is questioned. Our findings suggest that LLPDD is not related to depression on the basis of this marker and that hypothyroidism is not the cause of LLPDD.
黄体后期烦躁障碍（LLPDD），也称为经前烦躁症，在病因上与抑郁症和甲状腺疾病都有关联。我们对45名经前瞻性确诊患有LLPDD的健康女性在其月经周期的卵泡期和黄体期进行了基础及促甲状腺激素释放激素（TRH）刺激后的甲状腺功能检查。所有甲状腺变量的均值均正常。3名（6.8%）受试者基础促甲状腺激素（TSH）升高（轻度甲状腺功能减退），6名（13.3%）对TRH的促甲状腺激素反应（最大促甲状腺激素变化值）过度（亚临床甲状腺功能减退）。仅4.4%的受试者出现促甲状腺激素最大变化值降低（<5 mU/L）。既往有重大精神疾病诊断史（大多为抑郁症）或当前患有个性障碍与较低的促甲状腺激素最大变化值相关。由于使用新的超灵敏放射免疫分析法测得的基础TSH与促甲状腺激素最大变化值密切相关，因此对TRH激发试验的实用性提出了质疑。我们的研究结果表明，基于这一指标，LLPDD与抑郁症无关，且甲状腺功能减退不是LLPDD的病因。
