Matti Reinilä

Androgenic-anabolic steroid effects on serum thyroid, pituitary and steroid hormones in athletes

Endocrine responses in seven power athletes were investigated during a 12 week strength training period, when the athletes were taking high doses of andro genic-anabolic steroids, and during the 13 weeks fol lowing drug withdrawal. During the use of steroids significant decreases (P < 0.05 to 0.001) in the serum concentrations of thyroid stimulating hormone, thyrox ine, triidothyronine, free thyroxine, and thyroid hor mone-binding globulin (TBG) were found, whereas the value of triidothyronine uptake increased (P < 0.001). In relation to the changes in the thyroid function param eters measured, we suggest that the primary target of androgen action was TBG biosynthesis. In five of the seven subjects, serum concentrations of growth hor mone increased at some point of the study 5 to 60- fold. Because of the use of exogenous testosterone, serum testosterone concentration tended to increase. This increase was associated with a corresponding increase (P < 0.001) in serum estradiol. Furthermore, there were major decreases in serum LH (P < 0.01) and FSH (P < 0.01) concentrations, and testicular tes tosterone production was therefore decreased. This was characterized by a very low serum testosterone concentration (5.1 ± 1.8 nmol/l) 4 weeks following drug withdrawal. Cessation of drug use resulted in return of all the variables measured to the initial values, except for serum testosterone, which was at a low level (14.6 ± 8.8 nmol/l) 9 weeks after drug withdrawal, indicating prolonged impairment of testicular endocrine function. No consistent changes were found in the eight control athletes.

Hypoprolactinemia and ovarian function.

Thirty-two patients with ovarian hyperstimulation were randomized to receive bromocriptine or placebo from cycle day 5 onward. Bromocriptine decreased serum and follicular fluid prolactin (PRL), accelerated ovarian follicle growth, increased serum and follicular fluid estradiol, lowered luteal phase progesterone, and shortened the luteal phase length of the cycle. The maximal luteal phase estradiol and progesterone concentrations correlated with each other in the placebo group, but not in the bromocriptine group. These findings indicate that hypoprolactinemia interferes with ovarian function. The unchanged concentrations of gonadotropic hormones and pattern of luteinizing hormone pulsation during bromocriptine suggest direct ovarian effects of hypoprolactinemia. Because PRL suppression enhanced follicular responses and inhibited corpus luteum formation and function, the follicular and corpus luteum actions of PRL may be different.

Placebo-controlled comparison of hormonal and biochemical effects of danazol and high-dose medroxyprogesterone acetate.

The hormonal and biochemical effects of danazol (600 mg a day) and high-dose medroxyprogesterone acetate (MPA; 100 mg a day) were studied in a placebo-controlled, 6-month trial. Serum gonadotrophins and prolactin levels did not change during danazol and MPA treatments, whereas oestradiol and progesterone levels decreased significantly in relation to placebo without any difference between danazol and MPA. Both drugs significantly suppressed the sex hormone-binding globulin level (SHBG), and consequently, the free-androgen index (serum total testosterone nmol/l per SHBG nmol/l x 100) as compared with placebo, the effect of danazol being significantly stronger than that of MPA. Danazol, but not MPA, significantly increased serum aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and haemoglobin levels, and also thrombocyte counts, whereas MPA, but not danazol, increased the serum concentration of albumin in relation to placebo. Serum total bilirubin, conjugated bilirubin, gamma-glutamyl transferase, creatinine, alkaline phosphatase, sodium and potassium levels and leucocyte counts remained unchanged during both treatments. Danazol and high-dose MPA did not differ from each other in their ovarian and anterior pituitary effects, while the increase in androgenic activity induced by danazol was greater than that achieved with MPA. Danazol also had more biochemical effects than MPA. It interfered with the functions of the liver and the production of thrombocytes and haemoglobin, whereas MPA affected only albumin synthesis/release.

Exercise-induced proteinuria in children and adolescents

Urinary albumin and beta 2-microglobulin excretion rates were measured by radioimmunological methods in 60 children and adolescents at rest and during physical exercise. The geometric mean of the albumin excretion rate was 4.4 (microgram/min)/m2 at rest and rose to 7.9 (micrograms/min)/m2 during exercise (P less than 0.001), while the geometric mean of beta 2-microglobulin was 31.9 (ng/min)/m2 at rest and 26.2 (ng/min)/m2 during exercise. These results indicate that exercise-induced proteinuria is of a glomerular leaking type. The albumin excretion rate was not dependent on the age or sex of the subjects. The exercise-induced albuminuria correlated weakly but significantly with the maximal blood pressure (r = 0.27; P less than 0.05) and with the physical fitness of the subjects (r = 0.28; P less than 0.05).

Adrenal Response to Synthetic Adrenocorticotrophic Hormone during Pregnancy and after Delivery, with Special Reference to Pre-Eclamptic and Hypertensive Pregnancy

AbstractThe response of the adrenal cortex to synthetic adrenocorticotrophic hormone (HomactidR) was studied in 49 patients during the last trimester of pregnancy and in 53 patients two days post partum. The plasma cortisol was determined by a fluorimetric method. In the patients with severe pre-eclampsia the adrenal response was weaker than in normal control patients both during pregnancy and after delivery. Mild pre-eclampsia did not affect adrenocortical activity. The adrenocortical response of patients with hypertensive disease was as strong as that of the control group but shorter in duration. Short-term synthetic adrenocorticotrophin test is useful in the examination of adrenal disorders during pregnancy and after delivery.

Placental steroid synthesis from DHEAS during dexamethasone therapy.

Maternal glucocorticoid treatment affects estrogen synthesis by decreasing estrogen precursors. Whether glucocorticoid has any effect on the placental conversion of estrogen precursors to estrogen is not known. A study was therefore undertaken to investigate the effect of 100 mg of intravenously administered dehydroepiandrosterone sulfate (DHEAS) on estradiol (E2), estriol (E3), and testosterone (T) serum levels. The test was conducted for 5 hours in 10 women treated with intramuscular dexamethasone and in 8 controls during the last trimester of pregnancy. The initial E2 and E3 serum concentrations were lower in women treated with dexamethasone than in controls, while T serum levels did not display any difference. Following the injection of DHEAS there was a significant increase in E2, with maximal levels reached between 1 and 3 hours after injection in both groups. Maximal levels of E2 were equal for both groups. There was no change in E3 levels after DHEAS administration in the nontreated group, while the increase in the dexamethasone group was significant. A significant rise in T, with maximal levels reached at 1 hour after infusion, was similar in both groups. It is concluded that maternal dexamethasone does not inhibit the conversion of DHEAS either to E2 in the placenta or to E3 and T.

Haematological values for the finnish reindeer

SummaryRed blood cell counts, haemoglobin, packed cell volumes and total and differential leucocyte counts as well as E-MCHC, E-MCH, E-MCV values and the osmotic fragility of erythrocytes are described for the Finnish reindeer. The samples were taken in early autumn from 52 reindeer of varying ages.ZusammenfassungEs wurden in dieser Arbeit folgende Blutwerte beim finnischen Rentier untersucht: die Erythrozytenzahl, die Leukozytenzahl und das Differentialblutbild sowie der Hämatokritwert und das Hämoglobin, das mittlere Erythrozytenvolumen, die mittlere Hb-Konzentration der Erythrozyten, das mittlere Hämoglobin der Erythrozyten und die osmotische Resistenz. Die Blutproben wurden im Oktober 52 Rentieren entnommen. Die Tiere waren 1/2 bis 12 Jahre alt.

Thyroid Function Assay Using the Effective Thyroxine Ratio (ETR) in Infancy

Effective thyroxine ratio (ETR) and total serum thyroxine (T4) estimations have been performed on 119 healthy infants divided into three groups according to birthweight and gestational age (normal, small-for-age, and preterm). ETR and T4 were determined at 1 and 5 days and at 1, 3, 6 and 12 months. During the first month the values of both ETR and T4 were significantly higher than at the age of 3 months and later. This marked postnatal spurt of thyroid activity, which is probably due to increased secretion of the thyroid-stimulating hormone, was slightly lower in small-for-age and preterm infants than in fullterm ones. From the age of 3 months onwards the values of both ETR and T4 were similar to those of adults.

INTRA‐AMNIOTIC OR INTRAVENOUS INJECTION OF DEHYDROEPIANDROSTERONE SULPHATE: SIMULTANEOUS CHANGES IN STEROID LEVELS IN AMNIOTIC FLUID AND MATERNAL SERUM

Levels of unconjugated oestradiol‐17β (E2) and testosterone (T) and total oestriol (E3) were measured hourly for 6 h after intra‐amniotic (i.a.) (100–200 mg) or intravenous (i.v.) (100 mg) injection of dehydroepiandrosterone sulphate (DHEA‐S) in a series of twenty‐six women with mid‐trimester abortion. Amniotic fluid E2 and T levels were elevated significantly 1–6 h after the i.a. injection of DHEA‐S, while the E3 level in amniotic fluid did not change. The i.a. administration also induced significant rises in serum E2 and T levels between 1 and 6 h and in the serum E3 level between 2–6 h. The i.v. injection of DHEA‐S was accompanied by significantly elevated serum levels of E2 and T, while the E3 concentration remained unchanged. It appears that following maternal i.v. administration or an amniotic fluid injection, DHEA‐S is rapidly converted to E2 and T, and these accumulate in both the maternal circulation and the amniotic fluid. E3, however, is formed only after i.a. administration of DHEA‐S, and is selectively transported to the maternal blood.

MATERNAL SERUM PROLACTIN AND ITS RESPONSE TO TRH IN NORMAL AND COMPLICATED EARLY PREGNANCY

Maternal serum prolactin levels (PRL) were measured by radioimmunoassay in thirty‐four women with either normal or complicated early pregnancy. The basal PRL level (mean ± S.D.) of 33.4 ± 16.4 ng/ml in normal pregnancy (n= 15) was similar to the level of 32.7 ± 18.8 ng/ml in threatened abortion (n= 11) and 32.8 ± 16.9 ng/ml in hyperemesis gravidarum (n= 8). Two patients, one with blighted ovum and the other with subsequent spontaneous abortion, demonstrated PRL levels lower than the range of 20–63 ng/ml in the control group. The PRL response to 200 μg of synthetic thyrotropin releasing hormone (TRH) administered intravenously was similar throughout the patient groups. The basal level of PRL in the whole series was more closely related to the level of serum oestradiol (r= 0.778, P < 0.001) than to that of serum progesterone (r= 0.442, P < 0.05). However the increments of PRL following TRH administration did not correlate with either oestradiol or progesterone.