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Ovarian and Adrenal Androgens and Their Link to High Human Chorionic Gonadotropin Levels: A Prospective Controlled Study

机译:卵巢和肾上腺雄激素及其与人类绒毛膜促性腺激素水平高相关的前瞻性对照研究

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摘要

Background. Although the association between human chorionic gonadotropin (hCG) and hyperandrogenism was identified more than 40 years ago, relevant questions remain unanswered. Design and Methods. We conducted a prospective, longitudinal, and controlled study in 23 women with a diagnosis of a complete hydatidiform mole (HM). Results. All participants completed the study. Before HM evacuation mean hCG was markedly higher in the cases than in the control group (P ≤ 0.001). Free testosterone (T) and dehydroepiandrosterone sulfate (DHEA-S) were found to be higher in the cases (2.78 ± 1.24 pg/mL and 231.50 ± 127.20 μ/dL) when compared to the control group (1.50 ± 0.75 pg/mL and 133.59 ± 60.69 μ/dL) (P = 0.0001 and 0.001), respectively. There was a strong correlation between hCG and free T/total T/DHEA-S concentrations (r = 0.78; P ≤ 0.001, r = 0.74;  P ≤ 0.001, and r = 0.71;  P ≤ 0.001), respectively. In the cases group 48 hours after HM evacuation, hCG levels were found to be significantly lower when compared to initial levels (P = 0.001) and free T and DHEA-S declined significantly (P = 0.0002 and 0.009). Conclusion. Before uterus evacuation, hCG, free T, and DHEA-S levels were significantly higher when compared with controls finding a strong correlation between hCG and free T/DHEA-S levels. Forty-eight hours after HM treatment hCG levels declined and the difference was lost. A novel finding of our study is that in cases, besides free T, DHEA-S was also found to be significantly higher and both the ovaries and adrenal glands appear to be the sites of this androgen overproduction.
机译:背景。尽管人类绒毛膜促性腺激素(hCG)和雄激素过多症之间的关联已被确定40多年,但相关问题仍未得到解答。设计和方法。我们在23名女性中进行了一项前瞻性,纵向和对照研究,诊断出完全的葡萄胎(HM)。结果。所有参与者均完成了研究。 HM撤离前,病例中的平均hCG明显高于对照组(P≤0.001)。发现游离睾丸激素(T)和硫酸脱氢表雄酮硫酸盐(DHEA-S)与对照组(1.50±0.75 pg / mL和1.75±1.24 pg / mL和231.50±127.20μ/ dL)相比更高。分别为133.59±±60.69μ/ dL(P = 0.0001和0.001)。 hCG与游离T /总T / DHEA-S浓度之间有很强的相关性(r = 0.78; P≤0.001,r = 0.74; P≤0.001,r = 0.71; P≤0.001)。在HM撤离后48小时的病例组中,发现hCG水平明显低于初始水平(P = 0.001),游离T和DHEA-S显着下降(P = 0.0002和0.009)。结论。子宫排空前,与对照组相比,hCG,游离T和DHEA-S水平显着较高,而对照组发现hCG和游离T / DHEA-S水平之间存在很强的相关性。 HM治疗后48小时,hCG水平下降,差异消失。我们研究的一个新发现是,在某些情况下,除了游离T外,DHEA-S也明显更高,而卵巢和肾上腺都似乎是雄激素过量产生的场所。

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