子宫肌瘤患者GH-ICF-I轴与性激素的变化

目的:探讨GH-IGF-Ⅰ轴及性激素的变化与子宫肌瘤生长的关系。方法:选择年龄在30～55岁子宫肌瘤患者41例,其中增殖期21例,分泌期20例;年龄在33～53岁健康妇女40例作为对照组,其中增殖期21例,分泌期19例。采用免疫放射法(IRMA)测定血清生长激素(GH)、胰岛素样生长因子-1(IGF-Ⅰ)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平;放射免疫法(RIA)测定血清雌二醇(E_2)、孕酮(P)、睾酮(T)水平。结果:①肌瘤组分泌期GH、IGF-Ⅰ、IGFBP-3比对照组明显降低(P<0.01);而在增殖期肌瘤组的IGFBP-3比对照组也明显降低(P<0.05),但GH、IGF-Ⅰ则降低不明显;②增殖期肌瘤组的T水平较对照组明显降低(P<0.05);③子宫肌瘤组在增殖期IGF-Ⅰ与年龄呈显著的负相关关系(P<0.05),在分泌期IGF-Ⅰ与IGFBP-3呈显著的正相关(P<0.05),E_2与P无论在增殖期(P<0.01)还是分泌期均有显著的正相关(P<0.05)。与对照组明显不同的是T与E_2、与P的相关关系,及E_2与年龄的相关关系不存在了。而GH在增殖期与IGFBP-3呈正相关(P<0.05),与P也呈正相关(P<0.05),在分泌期GH与E_2则有非常显著的正相关关系(P<0.01)。结论:①GH轴的变化是由年龄决定的,随着年龄的增长,GH、IGF-Ⅰ、IGFBP-3相应的降低,在此过程中性激素,尤其E_2起主要调节作用。子宫肌瘤患者在增?

Alteration of the Serum Steroids and GH/IGF-l Axis in the Patients of Uterine Leiomyoma

Objective: To study the relationship between the growth hormone - insulin - like growth factor -I(GH/IGF-I) axis and women uterine leiomyomas. Methods: 41 women with leiomyoma aged 30 - 55y were observed, among them 21 in follicular and 20 in luteal phases of the cycle. 40 normal women aged 33 -53y were as control, among them 21 in follicular and 19 in luteal phases of the cycle . The fasting serum GH, IGF-I, IGFBP-3 were measured by IRMA method and E2, P, T were measured by RIA method. Results: The leiomyoma patients had less concentration of GH, IGF - I, IGFBP - 3 than that in control group in the secretion phase(P < 0. 01) , and lower IGFBP - 3 than that in control group in the proliferous phase. There was decrease in E2, P of the leiomyoma patients but no significant difference. The testosterone was significantly declined than that in control group in the proliferous phase. There were negative correlation be-tween IGF - I and age, and positive correlation between IGF - I and IGFBP - 3. There were positive correla-tions between E2 and P and T, and negative correlation betweenE2 and age in normal women. However, there were no correlations between T and E2 or T and P in leiomyoma women. There were no correlations be-tween E2 and age. But there were positive correlations between GH and IGFBP - 3 or GH and P or GH and E2. Conclusion: The effect of changes in the ovarian steroid on the GH axis depends on ages. The concen-tration of GH, IGF - I, IGFBP -3 decrease with aging, and ovary steroids also decline. They are reciprocal regulated by estradiol on the GH axis. GH, IGF - I play an important role in immunity system. The decrea-sing immunity may lead to the growth and genesis of uterine leiomyoma.