McKenna T J, Fearon U, Clarke D, Cunningham S K
Department of Endocrinology, St Vincent's Hospital, Dublin, Ireland.
Baillieres Clin Obstet Gynaecol. 1997 Jun;11(2):229-48. doi: 10.1016/s0950-3552(97)80035-1.
The reticularis and fasciculata zones of the adrenal cortex are the predominant sources of dehydroepiandrosterone (DHEA) and DHEA-sulphate and contribute directly or indirectly 60-75% of androstenedione and testosterone in women. The specific control of adrenal androgens remains unclear. While ACTH stimulates adrenal androgen secretion, the dissociation of cortisol and androgens occurring during adrenarche and under pathological conditions suggests other factors are involved. Recent studies using human adrenal cells in vitro have demonstrated that the ratio of androgen to cortisol produced is substantially independent of the age and gender of the adrenal, indicating that extra-adrenal factors are of greater importance. beta-Endorphin and joining peptide have been shown to stimulate androgen production in human adrenal cells and to influence ACTH-stimulated steroidogenesis in a manner that promotes adrenal androgen production. The activity of these pro-opiomelanocortin-derived peptides may explain the physiological and pathological dissociations of androgens and cortisol.
肾上腺皮质的网状带和束状带是脱氢表雄酮（DHEA）和硫酸脱氢表雄酮的主要来源，在女性中直接或间接贡献了60%-75%的雄烯二酮和睾酮。肾上腺雄激素的具体调控机制尚不清楚。虽然促肾上腺皮质激素（ACTH）刺激肾上腺雄激素分泌，但在肾上腺初现期及病理情况下皮质醇与雄激素的解离表明还有其他因素参与其中。最近利用人肾上腺细胞进行的体外研究表明，所产生的雄激素与皮质醇的比例基本上与肾上腺的年龄和性别无关，这表明肾上腺外因素更为重要。β-内啡肽和连接肽已被证明可刺激人肾上腺细胞产生雄激素，并以促进肾上腺雄激素产生的方式影响ACTH刺激的类固醇生成。这些源自阿片促黑激素皮质素原的肽的活性可能解释了雄激素与皮质醇在生理和病理上的解离。
