The state of steroidogenesis in the adrenal glands and gonads in patients with polycystic ovary with inhibition of gonadotropic function

A. Dobracheva, N. Goncharov, T. Todua, I. D. Nizharadze
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Abstract

Relationships between secretion of pituitary gonadotropic hormones, adrenal glucocorticoid and androgenic function, and ovarian steroid production were studied in 14 patients with the polycystic ovaries syndrome (POS) under conditions of suppressed endogenous gonadotropic secretion, which was induced by tonic administration of busereline, a GnRH agonist. The bRH/iRH ratio is not changed in POS patients under conditions of suppressed gonadotropic secretion. Inhibition of gonadotropic secretion leads to decrease of estrogen secretion in the ovaries and does not affect the adrenal glucocorticoid function. Activation of adrenal androgen production by the delta-5 pathway was observed in 57% patients under conditions of gonadotroph inhibition. Three months after busereline was discontinued, adrenal steroidogenesis normalized. The results permit a conclusion that prolonged inhibition of gonadotropic secretion with GnRH agonist does not change the bLH/iLH ratio but can lead to activation of adrenal androgen production in part of patients with POS.
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促性腺功能抑制的多囊卵巢患者肾上腺和性腺甾体生成状态
本文研究了14例多囊卵巢综合征(POS)患者在补服促性腺激素受体激动剂busereline抑制内源性促性腺激素分泌的情况下,垂体促性腺激素、肾上腺糖皮质激素和雄激素功能的分泌与卵巢类固醇生成的关系。促性腺激素分泌受到抑制的情况下,POS患者的bRH/iRH比值没有变化。抑制促性腺激素分泌导致卵巢雌激素分泌减少,不影响肾上腺糖皮质激素功能。在促性腺激素抑制的情况下,57%的患者观察到δ -5途径激活肾上腺雄激素的产生。停药3个月后,肾上腺类固醇生成恢复正常。结果表明,GnRH激动剂长期抑制促性腺激素分泌不会改变bLH/iLH比值,但会导致部分POS患者肾上腺雄激素分泌的激活。
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