[The characteristics of the hypothalamic monoaminergic regulation of adrenal cortical function in patients with hyperandrogenemia]. / Osobennosti gipotalamicheskoi monoaminergicheskoi reguliatsii funktsii kory nadpochechnikov u bol'nykh s giperandrogenemiei.

Since the majority of monoamines cannot penetrate through the hematoencephalic barrier, it is difficult to study their central metabolic disturbances. The ethymisole test was used to study the adrenocortical function in patients with hyperandrogenemia; ethymisole can penetrate through this barrier, it stimulates the brain structures that regulate adrenocortical function via endogenic monoamines activation. In 10 patients with the common form of ovarian polycystosis the ACTH and hydrocortisone response to ethymisole administration was virtually the same as in the reference group. This response was enhanced in 13 patients with ovarian polycystosis and adrenal hyperandrogenemia, and it could be arrested by ciproheptadin. This fact evidences, that the adrenal component of hyperandrogenemia is explained by hyperactivity of the hypothalamic serotoninergic systems, that regulate the secretion of corticotropin releasing factor. In 8 patients with ovarian polycystosis and functional hyperprolactinemia ACTH and hydrocortisone reaction to ethymisole administration was reduced; such type of response is observed in metoclopramide blocking of dopaminergic receptors. This fact points to the presence of hypothalamic dopaminergic insufficiency in the patients with ovarian polycystosis and hyperprolactinemia, this insufficiency involving not only the adrenocortical function regulating centers, but, possibly, the tuberoinfundibular system structures as well.

[Features of the adrenal cortex function in patients with hyperandrogenism of various etiology]. / Osobennosti funktsii kory nadpochechnikov u bol'nykh s giperandrogeniei razlichnogo geneza.

ACTH, prolactin, hydrocortisone, 17 OH-progesterone, androstenedione, dehydroepiandrosterone C, and testosterone were measured in the blood of 36 androgenic women and 8 healthy ones before and after adrenal stimulation. The findings evidence that various mechanisms are responsible for the development of androgynism of an adrenal origin. In patients with congenital virilizing adrenocortical hyperplasia and 21 hydroxylase deficiency excessive androgen production results mainly from activation of delta-4 route of androgen synthesis; in patients with adrenal androgynism and insufficiency of enzymic systems of steroidogenesis the androgen production is explained by functional hyperactivity of the bundle and retinal zones of the adrenal cortex and hyperreactivity to stimulating factors. Hyperproduction of androgens is related to ovarian hyperproduction of not only androstenedione and testosterone, but, in some patients, of dehydroepiandrosterone C as well. Elevated basal blood level of this enzyme cannot be regarded as a sufficiently reliable criterion in the differential diagnosis of the adrenal or ovarian origin of androgynism.

[The therapeutic effect of parlodel in the polycystic ovary syndrome]. / Lechebnyi éffekt parlodela pri sindrome polikistoznykh iaichnikov.

Parlodel (2.5-50 mg/day) has been given for 1 to 7 days to 33 patients with the polycystic ovary syndrome (POS). The ovulatory menstrual cycle returned in 10 (30%) patients and 4 of them conceived. Pretreatment cycle disturbance persisted in 6 (18%) patients. Parlodel reduced mid-follicular mean blood LH levels to values of normal women. Some decrease in blood testosterone levels occurred only in the second phase of the cycle. Estradiol test in 6 patients showed normal positive and negative feedbacks in the hypothalamic-pituitary-ovarian axis. Parlodel treatment reduced basal and estradiol stimulated pituitary gonadotropin secretion. It is suggested that parlodel may be used in ovulation induction in a proportion of POS patients.

[Blood sugar level and immunoreactive insulin in the blood plasma in pregnant women with supposed prediabetes in the dynamics of a normal glucose tolerance test]. / Soderzhanie sakhara v krovi i immunoreaktivnogo insulina v plazme krovi u beremennykh zhenshchin s predpolagaemym prediabetom v dinamike normal'noi proby na tolerantnost' k gliukoze

A study was made of the blood sugar level and blood plasma immunoreactive insulin (IRI) on fasting stomach and in the GTT dynamics in 33 pregnant women with a possible prediabetes and also in 8 nonpregnant women and 20 pregnant women of the control group. GTT proved to be normal in all the women under study. There proved to be no significant difference between the blood sugar level on fasting stomach and in the GTT dynamics in pregnant women of both groups and in the nonpregnant women. In comparison with nonpregnant women, pregnant women of both groups displayed a higher mean blood sugar elevation during the whole GTT period--in the II and III trimesters. Blood plasma IRI in the pregnant women with a possible prediabetes and in the pregnant women of the control group on fasting stomach and in the GTT dynamics showed no significant difference between one another. In comparison with nonpregnant women, pregnant women of both groups showed an increase in IRI content of fasting stomach and in the GTT dynamics beginning from the II trimester and reaching the maximal level during the III trimester of pregnancy. IRI over glucose index did not differ in pregnant women of both groups from the nonpregnant women. Thus it was revealed that hyperinsulinemia in pregnancy in practically healthy women and in women with a possible prediabetes was compensatory in character.

[Blood sugar and plasma immunoreactive insulin levels in healthy pregnant women undergoing the glucose tolerance test]. / Soderzhanie sakhara v krovi i immunoreaktivnogo insulina v plazme krovi u zdorovykh beremennykh zhenshchin v dinamike proby na tolerantnost' k gliukoze

The level of blood sugar and of blood plasma immunoreactive insulin (IRI) on fasting stomach and during the glucose (per os) tolerance test (GTT) were studied in apparently healthy 8 nonpregnant and 20 pregnant women (11 of them were examined once and 9 repeatedly in the course of pregnancy). GTT proved to be normal in all the women; there sere no signs pointing to the possibility of prediabetic state. Blood sugar on fasting stomach was somewhat lower in pregnant women than in the nonpregnant ones. Therefore, despite the absence of significant differences between the mean blood sugar values during the GTT in the pregnant and onopregnant women the mean sugar elevation during the whole GTT period was significantly higher in women of the III trimester of pregnancy than in the nonpregnant women. Blood plasma IRI content on fasting stomach during the II trimester of pregnancy had a tendency to elevation, and during the III trimester was significantly greater than in the nonpregnant women and in the I and II trimesters of pregnancy. The maximal blood plasma IRI elevation after taking glucose occurred later in the pregnant women was significantly higher during the II and the III trimesters than in the nonpregnant women. During the III trimester of pregnancy there was a singnificantly greater mean IRI elevation in the whole course of the GGT than in the nonpregnant women. IRI index showed no significant change in the pregnant women. The revealed character of the sugar and IRI ratio in the blood on fasting stomach and during the GTTpermits to suggest that hyperinsulinemia during pregnancy bore the character of a compensatory process. The absence of any changes in the IRI index pointed to the functional preservation of the insular apparatus in healthy pregnant women despite the fact that it was subject to a constant and increasing tension with the progress of pregnancy.