THE CONCOMITANT RELEASE OF ANDROSTENEDIONE WITH CORTISOL AND LUTEINIZING-HORMONE PULSATILE RELEASES DISTINGUISHES ADRENAL FROM OVARIAN HYPERANDROGENISM

被引：24

作者：

GENAZZANI, AD

PETRAGLIA, F

PIANAZZI, F

VOLPOGNI, C

GENAZZANI, AR

机构：

[1] Department of Obstetrics, University of Modena, Modena

[2] Department of Gynecology, University of Modena, Modena

来源：

GYNECOLOGICAL ENDOCRINOLOGY | 1993年 / 7卷 / 01期

关键词：

HYPERANDROGENISM; ANDROSTENEDIONE; PULSATILITY TEST; POLYCYSTIC OVARIAN DISEASE;

D O I：

10.3109/09513599309152477

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Androstenedione secretory characteristics and its possible temporal correlation with luteinizing hormone (LH) and/or cortisol, intended as the markers of, respectively, ovarian stimulation and adrenal secretion, were evaluated in 24 patients affected by dinical hyperandrogenism. A pulsatility test was carried out for 8 h, with sampling every 10 min, and LH, cortisol and androstenedione profiles were determined by radioimmunoassay. Time series were analyzed with the computer program DETECT and with a program for specific concordance estimation. A distinct episodic release of LH, cortisol and androstenedione was observed in all patients (6.9 +/- 0.8, 5.2 +/- 0.6 and 5.5 +/- 1 peaks/8 h, respectively). When specific concordance was tested between LH and androstenedione, and between cortisol and androstenedione, two distinct groups of patients could be identified. Group A (n = 13) showed a significant specific concordance (SC) index only for LH and androstenedione whik group B (n = 11) showed a significant SC also for cortisol and androstenedione, thus demonstrating a consistent adrenal participation in the androstenedione secretion in these patients. In addition, specific differences were observed on androstenedione secretory profiles of group B which showed a significant (p < 0.05) decrease of androstenedione plasma concentrations emulating cortisol behavior. No such observation was noted in group A, whose androstenedione plasma levels did not show any reduction. In conclusion, our data support the use of circulating androstenedione, LH and cortisol plasma levels and copulsatile assessment to distinguish the presence of two populations of hyperandrogenic patients: one whose hyperandrostenedionemia is mainly due to ovarian secretion (group A) and one which showed a hyperactivation of the adrenal gland (group B). This observation can be helpful for ensuring a correct therapeutical approach to the hyperandrogenic patient.

引用

页码：33 / 41

页数：9

共 19 条

[1]

Insler V., Lunenfeld B., Polycystic ovarian disease: a challenge and controversy, Gynecol. Endocrinol., 4, pp. 51-69, (1990)

[2]

Genazzani A.R., Pecciarini-Snickars L., De Leo V., Picciolini E., Tarascio P., Diagnostic approach to the hirsute patient, Horm. Res., 9, pp. 379-393, (1978)

[3]

Venturoli S., Porcu E., Fabbri R., Magrini O., Gammi L., Paradisi R., Forcacci M., Bolzani R., Flamigni C., Episodic pulsatile secretion of FSH, LH, prolactin, oestradiol, oestrone, and LH circadian variations in polycystic ovary syndrome, Clin. Endocrinol., 28, pp. 93-107, (1988)

[4]

Genazzani A.D., Guardabasso V., Petraglia F., Genazzani A.R., Specific concordance index defines the physiological lag between LH and progesterone in women during the midluteal phase of menstrual cycle, Gynecol. Endocrinol., 5, pp. 175-184, (1991)

[5]

Lejeune-Lenain C., Van Cauter E., Desir D., Beyloos M., Franckson J.R., Control of circadian and episodic variations of adrenal androgen secretion in man, J. Endocrinol. Invest., 10, pp. 267-276, (1987)

[6]

Rossmanith W.G., Laughlin G.A., Mortola J.F., Johnson M.L., Veldhuis J.D., Yen S.S.C., Pulsatile cosecretion of estradiol and progesterone by the midluteal phase corpus luteum: temporal link to luteinizing hormone pulses, J. Clin. Endocrinol. Metab., 70, (1990)

[7]

Follenius M., Simon C., Brandenberger G., Lenzi P., Ultradian plasma corticotropin and Cortisol rhythms: time series analyses, J. Endocrinol. Invest., 10, pp. 261-266, (1987)

[8]

Genazzani A.R., Pintor C., Facchinetti F., Inaudi P., Maci D., Corda R.D., Changes throughout puberty in adrenal secretion after ACTH, J. Steroid Biochem., 11, pp. 571-577, (1979)

[9]

Genazzani A.D., Guardabasso V., Rodbard D., Forti G., Application of peak-detection programs to clinical data, Computers in Endocrinology: Recent Advances, pp. 71-82, (1990)

[10]

Oerter K.E., Guardabasso V., Rodbard D., Detection and characterization of peaks and estimation of instantaneous secretory rate for episodic pulsatile hormone secretion, Computers Biomed. Res., 19, pp. 170-191, (1986)

← 1 2 →