Hypothalamus-pituitary-gonadal dysfunction in chronic uremic men
Shian, L.R.; Fan, C.D.; Huang, H.W.
Journal of the Formosan Medical Association 83(8): 814-820
1984
ISSN/ISBN: 0371-7682 PMID: 6440946 Document Number: 241401
The hypothalamus-pituitary-gonadal axis was studied in 20 chronic uremic men and 10 normal men. The mean age of uremic men was 37.9 .+-. 18.8 yr (mean .+-. SD) and the duration of uremia was 11.3 .+-. 9.5 mo. The mean age of control men was 31.7 .+-. 20.1 yr. Testicular functions included seminal fluid examination, also basal serum levels of testosterone, LH 100 .mu.g were given i.v. to each of the subjects, and venous blood samples were collected at -15, 0, 10, 20, 30, 60, 120, 180 and 240 min intervals during the test. The samples were assayed to disclose the prolactin, LH and FSH changes. Chorionic gonadotropin 3000 .mu. was given i.m. to each of the subjects daily for 5 days, and blood samples were drawn at day 1, 3 and 5 for determination of testosterone, E2 and E3 levels. The basal plasma testosterone level in uremic men was lower than that of control men (11.7 .+-. 1.74 ng/ml vs. 5.02 .+-. 3.59 ng/ml, P < 0.001). Plasma LH and prolactin levels were higher than that of the control (19.4 .+-. 15.9 vs. 81. .+-. 4.0 mIU/ml and 41.1 .+-. 24.5 vs. 10.0 .+-. 13.5 ng/ml; P < 0.05 and P < 0.01, respectively). The LH and prolactin responses to the TRH and GnRH stimulation revealed curve of delayed and prolonged response with a lower peak in uremic men as compared with that of the normal control curve. Chorionic gonadotropin stimulating tests revealed much lower testosterone response in uremic men than that of normal controls. Impairment of testicular function both in spermatogenesis and testosterone production was found in chronic uremic men. The hypothalamus-pituitary-gonadal axis also indicated abnormalities in the uremic men.