The serum prolactin, LH, FSH and testosterone were measured by RIA method for the evaluation of the hypothalamo-pituitary-testicular axis through the LHRH stimulation test before and after intramuscular injection of 50 mg of testosterone propionate(T.p.) in normal controls and patients with chronic renal failure (CRF) before specific treatment.
1. The basal level of the serum prolactin was significantly higher in the patients with CRF (124.9±46.3 ng/ml, M±S.E.) compared with normal controls(11.2±2.1 ng/ml).
2. The basal ·level of serum LH in normal controls was 7.1±1.4 mIU/ml and the peak level was 46.5±3.9 mIU/ml at 30 min. after iv injection of 100 ㎍ of LHRH.
In patients with CRF, the basal serum level of LH was 15.5±2.7 mIU/ml and peak level was 37.1±5.4 mIU/ml at 180 min. after administration of LHRH, showing delayed response to LHRH stimulation in patients with CRF.
After administration of T.p., the response of LH to LHRH stimulation in normal controls was suppressed, while in the patients with CRF, there was no significant difference between the responses before and after injection of T.p..
3. Basal serum FSH levels in normal controls was 3.2±0.4 mIU/ml, and at 60 min. after LHRH stimulation, level of the FSH was elevated to peak level significantly.
The basal serum level of FSH in patients with CRF was 2.9±0.9 mlIU/ml and elevated more slowly with LHRH stimulation compared with normal controls.
After injection of T.p., the basal levels of serum PSH and the responses to LHRH stimulation were not changed significantly in normal controls and the patients with CRF.
4. The basal serum level of testosterone was 5.2±0.4 ng/dl in normal controls. In the patients with CRF, the basal level of testosterone was significantly lower(3.5±0.8 ng/dl) than that of normal controls.
The serum testosterone level was not changed within 3 hours with LHRH stimulation in both normal controls and patients with CRF.
After administration of T.p., the basal levels of testosterone in patients and controls were elevated significantly but there was no response to LHRH stimulation.
With the above results, it can he concluded that the abnormal response of the pituitary gland to the change of testosterone level, elevated serum prolactin level, increased LH level, and abnormal response to LHRH stimulation contribute to the abnormal sexual functions in patients with CRF.
|