Pulsatile GnRH Therapy May Restore Hypothalamus–Pituitary–Testis Axis Function in Patients With Congenital Combined Pituitary Hormone Deficiency: A Prospective, Self-Controlled Trial
| العنوان: | Pulsatile GnRH Therapy May Restore Hypothalamus–Pituitary–Testis Axis Function in Patients With Congenital Combined Pituitary Hormone Deficiency: A Prospective, Self-Controlled Trial |
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| المؤلفون: | Shuyu Xiong, Mingxuan Cui, Junjie Zheng, Xueyan Wu, Zhaoxiang Liu, Xi Wang, Min Nie, Le Min, Hongli Xu, Ursula B. Kaiser, Jiangfeng Mao, Wanlu Ma, Bingkun Huang |
| المصدر: | The Journal of Clinical Endocrinology & Metabolism. 102:2291-2300 |
| بيانات النشر: | The Endocrine Society, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, endocrine system, medicine.medical_specialty, Hormone Replacement Therapy, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Hypothalamus, Pulsatile flow, 030209 endocrinology & metabolism, Infusions, Subcutaneous, Gonadotropic cell, Biochemistry, Drug Administration Schedule, Hypopituitarism, Gonadotropin-Releasing Hormone, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Hypogonadotropic hypogonadism, Internal medicine, Testis, Humans, Medicine, Endocrine system, Testosterone, Prospective Studies, Pituitary stalk, business.industry, Biochemistry (medical), Luteinizing Hormone, medicine.disease, Magnetic Resonance Imaging, 030104 developmental biology, Pituitary Gland, Follicle Stimulating Hormone, business, Luteinizing hormone, hormones, hormone substitutes, and hormone antagonists |
| الوصف: | Context The effectiveness of pulsatile gonadotropin-releasing hormone (GnRH) therapy in patients with congenital combined pituitary hormone deficiency (CCPHD) has not been investigated because of the limited number of patients, as well as these patients' presumed pituitary hypoplasia, poor gonadotrophic cell reserve, and impaired gonadotrophic response to GnRH. Objective To assess the pituitary response to pulsatile GnRH therapy in men with CCPHD. Design Prospective, self-controlled, 3-month clinical trial. Settings University endocrine clinic. Patients Men with hypogonadotropic hypogonadism caused by CCPHD. Intervention Pulsatile GnRH was administered subcutaneously for 3 months. Main outcome measures Primary endpoints were total serum testosterone, testicular volume, and luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. Secondary endpoints included occurrence of spermatogenesis. Results A total of 40 men with CCPHD completed the study. Of these, 60% (24 of 40) showed a good response to pulsatile GnRH treatment (response group). At 3 months, their LH and FSH levels increased to within the normal range and their testosterone levels increased to 8.67 ± 4.83 nmol/L. Of the patients in the response group, 33.3% (8 of 24) of them achieved spermatogenesis. The remaining 40% (16 of 40) of patients had a poor response to pulsatile GnRH treatment. Magnetic resonance imaging (MRI) did not reveal any correlation between pituitary response and pituitary height and/or integrity of the pituitary stalk. Conclusions This study suggests that gonadotrophs in patients with CCPHD can exist and be functional-even with MRI evidence of pituitary hypoplasia or dysplasia. Pulsatile GnRH therapy restored pituitary-testis axis function in 60% of patients with CCPHD. These results may directly guide the clinical therapeutic choice. |
| تدمد: | 1945-7197 0021-972X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bb3d65ded659080396960803380ea816Test https://doi.org/10.1210/jc.2016-3990Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....bb3d65ded659080396960803380ea816 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19457197 0021972X |
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