Ueshiba H, Takeda S, Matoba H, Tanaka Y, Yuasa R, Tsuboi K, Miyachi Y
First Department of Internal Medicine, Toho University School of Medicine, Tokyo, Japan.
Exp Clin Endocrinol Diabetes. 1997;105(6):359-62. doi: 10.1055/s-0029-1211779.
Thyroid hormone is known to affect androgen metabolism, however, there are few studies in which alterations of androgen metabolism are simultaneously examined in patients with clinical thyroid disorders. In this study, we investigated the alterations of thyroid hormone and androgens before and during treatment in patients with hyperthyroidism. Fifteen female patients with hyperthyroidism due to Graves' disease were studied. From these patients, blood samples were obtained before treatment and at 1 month (M), 2M, 3M, 4M and 6M after beginning of treatment. Concentrations of free T4(FT4), free T3(FT3), testosterone (T), androstenedione (delta 4A), dihydrotestosterone (DHT), 5 alpha-androstane-3 alpha, 17 beta-diol(3 alpha-diol) and androsterone (AD) and sex hormone binding globulin (SHBG) were measured by radioimmunoassays (RIAs) or immunoradiometric assay (IRMA). As normal controls, ten healthy women were also studied. Before treatment concentrations of DHT (mean +/- SD: 3.35 +/- 0.78 nmol/L), 3 alpha-diol (0.78 +/- 0.11 nmol/L), AD (6.73 +/- 0.64 nmol/L) and SHBG (184.9 +/- 68.1 nmol/L) were significantly elevated compared with those of normal controls. T and delta 4A levels were not significantly different from normal values. DHT/T ratio indicating 5 alpha-reductase activity was 4.62 +/- 2.55 and significantly higher than that in normal controls. At 2 months after beginning of treatment with anti-thyroid drugs, thyroid function (FT4 and FT3) became normal and at 3 months after beginning of treatment, DHT, 3 alpha-diol, AD and DHT/T ratio decreased to normal range. SHBG level was gradually decreased, however still higher than that of the normal control group at 6 months after beginning of treatment. There was a time lag in recovery between serum androgen levels and SHBG level.
已知甲状腺激素会影响雄激素代谢,然而,很少有研究同时检测临床甲状腺疾病患者雄激素代谢的变化。在本研究中,我们调查了甲状腺功能亢进症患者治疗前及治疗期间甲状腺激素和雄激素的变化。研究了15例因格雷夫斯病导致甲状腺功能亢进的女性患者。从这些患者中,在治疗前以及开始治疗后1个月(M)、2M、3M、4M和6M采集血样。通过放射免疫分析(RIAs)或免疫放射分析(IRMA)测量游离T4(FT4)、游离T3(FT3)、睾酮(T)、雄烯二酮(δ4A)、双氢睾酮(DHT)、5α-雄烷-3α,17β-二醇(3α-二醇)、雄酮(AD)和性激素结合球蛋白(SHBG)的浓度。作为正常对照,还研究了10名健康女性。治疗前,DHT(平均值±标准差:3.35±0.78 nmol/L)、3α-二醇(0.78±0.11 nmol/L)、AD(6.73±0.64 nmol/L)和SHBG(184.9±68.1 nmol/L)的浓度与正常对照相比显著升高。T和δ4A水平与正常值无显著差异。表明5α-还原酶活性的DHT/T比值为4.62±2.55,显著高于正常对照。在用抗甲状腺药物治疗开始后2个月,甲状腺功能(FT4和FT3)恢复正常,在治疗开始后3个月,DHT、3α-二醇、AD和DHT/T比值降至正常范围。SHBG水平逐渐下降,但在治疗开始后6个月仍高于正常对照组。血清雄激素水平和SHBG水平的恢复存在时间滞后。