Kadva A, Djahanbakhch O, Monson J, Di W L, Silman R
Department of Obstetrics and Gynaecology, St. Bartholomew's and the Royal London School of Medicine and Dentistry, Whitechapel, United Kingdom.
J Clin Endocrinol Metab. 1998 Oct;83(10):3653-62. doi: 10.1210/jcem.83.10.5155.
Elevated nocturnal melatonin is found in women with idiopathic hypogonadotropic hypogonadism (IHH), but it is not known whether this is implicated in the etiology of their GnRH deficiency. It is unlikely that nocturnal melatonin can be implicated in the etiology of the GnRH deficiency of Kallmann's syndrome (KS), because this condition is caused by defective neuronal migration in embryonic life. We therefore measured nocturnal melatonin in women with IHH and KS to determine whether it was elevated in one or both conditions and thereby to determine whether it was implicated as cause or consequence of GnRH deficiency. Four women with IHH, 3 women with KS, and 7 individually matched (age and body size) controls were recruited. Frequent day- and nighttime samples were taken for LH pulsatility studies. All patients showed absent or diminished LH pulsatility, compared with their respective controls. Samples were also taken over 24 h for melatonin and 6-sulphatoxymelatonin (the principle metabolite of melatonin and an independent marker of its secretion). Melatonin and 6-sulphatoxymelatonin levels were elevated in 6 of 7 patients (compared with their matched controls) and were significantly elevated in the KS group (compared with their controls). The finding of elevated nocturnal melatonin (and its metabolite) in GnRH-deficient women with KS (as well as IHH) suggests that nocturnal melatonin is elevated as a consequence of GnRH deficiency, irrespective of its etiology.
特发性低促性腺激素性性腺功能减退（IHH）女性患者夜间褪黑素水平升高，但尚不清楚这是否与她们促性腺激素释放激素（GnRH）缺乏的病因有关。夜间褪黑素不太可能与卡尔曼综合征（KS）的GnRH缺乏病因有关，因为这种疾病是由胚胎期神经元迁移缺陷引起的。因此，我们测量了IHH和KS女性患者的夜间褪黑素水平，以确定其在一种或两种情况下是否升高，从而确定其是否与GnRH缺乏的原因或结果有关。招募了4名IHH女性患者、3名KS女性患者和7名个体匹配（年龄和体型）的对照者。采集白天和夜间的频繁样本用于促黄体生成素（LH）脉冲性研究。与各自的对照者相比，所有患者的LH脉冲性均缺失或减弱。还在24小时内采集样本用于检测褪黑素和6-硫酸氧褪黑素（褪黑素的主要代谢产物及其分泌的独立标志物）。7名患者中有6名（与匹配的对照者相比）的褪黑素和6-硫酸氧褪黑素水平升高，KS组（与对照者相比）显著升高。在GnRH缺乏的KS（以及IHH）女性患者中发现夜间褪黑素（及其代谢产物）升高，这表明夜间褪黑素升高是GnRH缺乏的结果，与病因无关。
