The association among cytochrome P450 3A, progesterone receptor polymorphisms, plasma 17-alpha hydroxyprogesterone caproate concentrations, and spontaneous preterm birth.

BACKGROUND: Infants born <37 weeks' gestation are of public health concern since complications associated with preterm birth are the leading cause of mortality in children <5 years of age and a major cause of morbidity and lifelong disability. The administration of 17-alpha hydroxyprogesterone caproate reduces preterm birth by 33% in women with history of spontaneous preterm birth. We demonstrated previously that plasma concentrations of 17-alpha hydroxyprogesterone caproate vary widely among pregnant women and that women with 17-alpha hydroxyprogesterone caproate plasma concentrations in the lowest quartile had spontaneous preterm birth rates of 40% vs rates of 25% in those women with higher concentrations. Thus, plasma concentrations are an important factor in determining drug efficacy but the reason 17-alpha hydroxyprogesterone caproate plasma concentrations vary so much is unclear. Predominantly, 17-alpha hydroxyprogesterone caproate is metabolized by CYP3A4 and CYP3A5 enzymes. OBJECTIVE: We sought to: (1) determine the relation between 17-alpha hydroxyprogesterone caproate plasma concentrations and single nucleotide polymorphisms in CYP3A4 and CYP3A5; (2) test the association between progesterone receptor single nucleotide polymorphisms and spontaneous preterm birth; and (3) test whether the association between plasma concentrations of 17-alpha hydroxyprogesterone caproate and spontaneous preterm birth varied by progesterone receptor single nucleotide polymorphisms. STUDY DESIGN: In this secondary analysis, we evaluated genetic polymorphism in 268 pregnant women treated with 17-alpha hydroxyprogesterone caproate, who participated in a placebo-controlled trial to evaluate the benefit of omega-3 supplementation in women with history of spontaneous preterm birth. Trough plasma concentrations of 17-alpha hydroxyprogesterone caproate were measured between 25-28 weeks of gestation after a minimum of 5 injections of 17-alpha hydroxyprogesterone caproate. We extracted DNA from maternal blood samples and genotyped the samples using TaqMan (Applied Biosystems, Foster City, CA) single nucleotide polymorphism genotyping assays for the following single nucleotide polymorphisms: CYP3A4*1B, CYP3A4*1G, CYP3A4*22, and CYP3A5*3; and rs578029, rs471767, rs666553, rs503362, and rs500760 for progesteronereceptor. We adjusted for prepregnancy body mass index, race, and treatment group in a multivariable analysis. Differences in the plasma concentrations of 17-alpha hydroxyprogesterone caproate by genotype were evaluated for each CYP single nucleotide polymorphism using general linear models. The association between progesterone receptor single nucleotide polymorphisms and frequency of spontaneous preterm birth was tested using logistic regression. A logistic model also tested interaction between 17-alpha hydroxyprogesterone caproate concentrations with each progesterone receptor single nucleotide polymorphism for the outcome of spontaneous preterm birth. RESULTS: The association between CYP single nucleotide polymorphisms *22, *1G, *1B, and *3 and trough plasma concentrations of 17-alpha hydroxyprogesterone caproate was not statistically significant (P = .68, .44, .08, and .44, respectively). In an adjusted logistic regression model, progesterone receptor single nucleotide polymorphisms rs578029, rs471767, rs666553, rs503362, and rs500760 were not associated with the frequency of spontaneous preterm birth (P = .29, .10, .76, .09, and .43, respectively). Low trough plasma concentrations of 17-alpha hydroxyprogesterone caproate were statistically associated with a higher frequency of spontaneous preterm birth (odds ratio, 0.78; 95% confidence ratio, 0.61-0.99; P = .04 for trend across quartiles), however no significant interaction with the progesterone receptor single nucleotide polymorphisms rs578029, rs471767, rs666553, rs503362, and rs500760 was observed (P = .13, .08, .10, .08, and .13, respectively). CONCLUSION: The frequency of recurrent spontaneous preterm birth appears to be associated with trough 17-alpha hydroxyprogesterone caproate plasma concentrations. However, the wide variation in trough 17-alpha hydroxyprogesterone caproate plasma concentrations is not attributable to polymorphisms in CYP3A4 and CYP3A5 genes. Progesterone receptor polymorphisms do not predict efficacy of 17-alpha hydroxyprogesterone caproate. The limitations of this secondary analysis include that we had a relative small sample size (n = 268) and race was self-reported by the patients.

The involvement of gonadotropins and gonadal steroids in the ovulatory dysfunction of the potamodromous Salminus hilarii (Teleostei: Characidae) in captivity.

Potamodromous teleosts that require migration to reproduce show dysfunctions that block ovulation and spawning while in captivity. To understand the physiological basis of these reproductive dysfunctions, follicle-stimulating hormone b subunit (fshb) and luteinizing hormone b subunit (lhb) gene expression analyses by real-time quantitative PCR, together with measurements of estradiol (E 2), 17α-hydroxyprogesterone (17α-OHP) and 17α,20ß-dihydroxy-4-pregnen-3-one (17α,20ß-DHP) levels, were carried out throughout the reproductive cycle of the potamodromous Salminus hilarii. The following reproductive stages were evaluated in captive and wild females: previtellogenic (PV), advanced maturation/mature (AM) and regression/spent (REG/SPENT). In the wild females, fshb expression decreased from the PV to the AM stage, and the opposite pattern was detected for E 2, which increased from the PV to the AM stage. fshb was expressed at lower levels in captive than in wild females, and this difference did not change during the reproductive cycle. lhb expression also increased from the PV to the AM stage in both groups, but the wild females at the AM and REG/SPENT stages showed higher lhb expression levels than the captive females. The concentrations of 17α-OHP did not change during the reproductive cycle, and the levels were higher in the captive than in the wild females at all reproductive stages. 17α,20ß-DHP levels did not change between wild and captive females. However, in captive females, the transition from PV to AM stage was followed by an increase in 17α,20ß-DHP levels. These data indicate that dysfunctions in the gonadotropins and steroids synthesis pathways cause the ovulation failure in captive S. hilarii.

Relationship between 17-alpha hydroxyprogesterone caproate concentration and spontaneous preterm birth.

OBJECTIVE: 17-alpha hydroxyprogesterone caproate 250 mg weekly reduces recurrent spontaneous preterm birth in women with a prior spontaneous preterm birth by 33%. The dose is not based on pharmacologic considerations. A therapeutic concentration has not been determined hampering any attempt to optimize treatment. This study evaluated the relationship between 17-alpha hydroxyprogesterone caproate plasma concentrations and the rate of spontaneous preterm birth in women with singleton gestation. STUDY DESIGN: A single blood sample was obtained between 25 and 28 weeks' gestation from 315 women with a spontaneous preterm birth who participated in a placebo-controlled, prospective, randomized clinical trial evaluating the benefit of omega-3 supplementation in reducing preterm birth. All women in the parent study received 17-alpha hydroxyprogesterone caproate and 434 received omega-3 supplementation and 418 received a placebo. Plasma from 315 consenting women was analyzed for 17-alpha hydroxyprogesterone caproate concentration. RESULTS: There were no differences between placebo and omega-3 supplemented groups in demographic variables, outcomes or in mean 17-alpha hydroxyprogesterone caproate concentration. Plasma concentrations of 17-alpha hydroxyprogesterone caproate ranged from 3.7-56 ng/mL. Women with plasma concentrations of 17-alpha hydroxyprogesterone caproate in the lowest quartile had a significantly higher risk of spontaneous preterm birth (P = .03) and delivered at significantly earlier gestational ages (P = .002) than did women in the second to fourth quartiles. The lowest preterm birth rates were seen when median 17-alpha hydroxyprogesterone caproate concentrations exceeded 6.4 ng/mL. CONCLUSION: Low plasma 17-alpha hydroxyprogesterone caproate concentration is associated with an increased risk of spontaneous preterm birth. This finding validates efficacy of this treatment but suggests that additional studies are needed to determine the optimal dosage.

Relationship between 17-hydroxyprogesterone caproate concentrations and gestational age at delivery in twin gestation.

OBJECTIVE: We sought to evaluate in women with twin gestation the relationship between 17-hydroxyprogesterone caproate (17-OHPC) concentration and gestational age at delivery and select biomarkers of potential pathways of drug action. STUDY DESIGN: Blood was obtained between 24-28 weeks (epoch 1) and 32-35 weeks (epoch 2) in 217 women with twin gestation receiving 17-OHPC or placebo. Gestational age at delivery and concentrations of 17-OHPC, 17-hydroxyprogesterone, progesterone, C-reactive protein (CRP), and corticotrophin-releasing hormone were assessed. RESULTS: Women with higher concentrations of 17-OHPC delivered at earlier gestational ages than women with lower concentrations (P < .001). Women receiving 17-OHPC demonstrated significantly higher (P = .005) concentrations of CRP in epoch 1 than women receiving placebo but CRP values were similar in epoch 2 in both groups. A highly significant (P < .0001) positive relationship was observed between 17-OHPC concentration and progesterone and 17-hydroxyprogesterone concentrations at both epochs. Corticotropin-releasing hormone concentrations did not differ by treatment group. CONCLUSION: 17-OHPC may adversely impact gestational age at delivery in women with twin gestation.

Assessment of spermatogenesis and plasma sex steroids in a seasonal breeding teleost: a comparative study in an area of influence of a tributary, downstream from a hydroelectric power dam, Brazil.

River damming and building of hydroelectric power plants interrupt the reproductive migration routes and change the major physicochemical parameters of water quality, with drastic consequences for populations of migratory fishes. The goal of this study was to evaluate proliferation and cell death during spermatogenesis and serum profiles of sex steroids in Prochilodus argenteus, from the São Francisco River, downstream from the Três Marias Dam. A total of 257 adult males were caught quarterly during a reproductive cycle in two sites: the first 34 km of the river after the dam (site 1) and the second 34-54 km after the dam (site 2), after the confluence with a tributary, the Abaeté River. Seasonal changes in the testicular activity associated with morphometric analyses of germ cells as well as proliferation and testicular apoptosis support a more active spermatogenesis in fish from site 2, where higher levels of sex steroids and gonadosomatic index (GSI) were also found. In site 1, fish presented low serum levels of testosterone, 17ß-estradiol and 17α-hydroxyprogesterone and a low GSI during gonadal maturation. Spermatogonial proliferation (PCNA) and apoptosis (TUNEL) were more elevated in fish from site 1, but spermatocytes were mainly labelled in fish from site 2. Overall, these data demonstrate changes in testicular activity and plasma sex steroids in a neotropical teleost fish living downstream from a hydroelectric dam, supplying new data on fish reproduction in regulated rivers. Moreover, morphometric analyses associated with sex steroids profiles provide reliable tools to assess fish spermatogenesis under environmental stress conditions.

Steroid profiles in cultured female jundiá, the Siluridae Rhamdia quelen (Quoy and Gaimard, Pisces Teleostei), during the first reproductive cycle.

The jundiá Rhamdia quelen (Quoy and Gaimard) is a teleost species from the Siluridae family and is an important species for aquaculture in temperate and subtropical climates. Gonad and blood tissue samples were taken from cultured jundiá females between 1998 and 1999. Plasma concentrations of 17beta-estradiol (E(2)), testosterone (T), 11-ketotestosterone (11-KT), 17-hydroxy-4-pregnene-3,20-dione (17-P), 17,20beta-dihydroxy-4-pregnen-3-one (17,20beta-P), and 17,20beta,21-trihydroxy-4-pregnen-3-one (20beta-S) were measured by radioimmunoassay and potential correlations with the stage of oogenesis and sexual maturation examined. During the experimental period two spawning episodes were observed. Plasma concentrations of E(2) increased progressively during oocyte development, simultaneously with the appearance of yolk vesicles and increasing amounts of deposited yolk. In female jundiá, the T peak occurred in October and was coincident with the peak in gonadosomatic index. Two distinct peaks of progestogens were detected, corresponding to the two spawning episodes, suggesting that one or more of these steroids might act as the "maturational-inducing steroid" in jundiá. Unusually large amounts of 11-KT were also measured in the plasma of mature jundiá females. The identity of 11-KT was confirmed by thin-layer chromatography. Although the profiles of the other steroids are compatible with the roles proposed for the action of these hormones in other teleosts, the role of 11-KT, normally found only in males, is unknown.

Gonadotropinas y sexoesteroides en mujeres posmenopáusicas del círculo de abuelos

En publicaciones recientes se han evaluado varios factores que pueden influir en las hormonas de la reproducción durante el climaterio. En nuestro medio no existen investigaciones sobre esta problemática, razón por la cual se diseñó este estudio con el objetivo de conocer la relación entre los niveles hormonales posmenopáusicos y la actividad en los círculos de abuelos. Se seleccionó una muestra simple aleatoria de 134 mujeres posmenopáusicas, estratificada según participaran o no en el círculo de abuelos (67 en cada estrato), de un área de salud urbana. Se determinaron por radioinmunoanálisis las siguientes hormonas: FSH, LH, prolactina, testosterona, estradiol 17 beta, androstenediona y 17 hidroxiprogesterona (17 OH-P). La prolactina fue mayor en las mujeres que no participan en las actividades del círculo de abuelos, mientras que la testosterona y la 17 OH-P fueron menores con respecto al grupo que participa en el círculo de abuelos. El resto de las hormonas no mostró diferencias entre los 2 grupos. Según estos resultados, las actividades realizadas por estas mujeres en el círculo de abuelos influyen en los niveles de algunas de las hormonas de la reproducción, lo que pudiera tener efectos favorables para la salud, al disminuir el estrés y en particular sobre la osteoporosis que se desarrolla en esta época de la vida (AU)

Gonadotropinas y sexoesteroides en mujeres posmenopáusicas del círculo de abuelos

En publicaciones recientes se han evaluado varios factores que pueden influir en las hormonas de la reproducción durante el climaterio. En nuestro medio no existen investigaciones sobre esta problemática, razón por la cual se diseñó este estudio con el objetivo de conocer la relación entre los niveles hormonales posmenopáusicos y la actividad en los círculos de abuelos. Se seleccionó una muestra simple aleatoria de 134 mujeres posmenopáusicas, estratificada según participaran o no en el círculo de abuelos (67 en cada estrato), de un área de salud urbana. Se determinaron por radioinmunoanálisis las siguientes hormonas: FSH, LH, prolactina, testosterona, estradiol 17 beta, androstenediona y 17 hidroxiprogesterona (17 OH-P). La prolactina fue mayor en las mujeres que no participan en las actividades del círculo de abuelos, mientras que la testosterona y la 17 OH-P fueron menores con respecto al grupo que participa en el círculo de abuelos. El resto de las hormonas no mostró diferencias entre los 2 grupos. Según estos resultados, las actividades realizadas por estas mujeres en el círculo de abuelos influyen en los niveles de algunas de las hormonas de la reproducción, lo que pudiera tener efectos favorables para la salud, al disminuir el estrés y en particular sobre la osteoporosis que se desarrolla en esta época de la vida

Diagnóstico e prevalência da hiperplasia adrenal congênita forma näo clássica em uma amostra de 122 pacientes hirsutas / Diagnosis and prevalence of nonclassical congenital adrenal hyperplasia in 122 hirsute patients

OBJETIVOS: Estabelecer o diagnóstico de HAC-NC e a prevalência desta patologia no nosso meio, em pacientes consultando por hirsutismo. PACIENTES E MÉTODOS: Foram avaliadas do ponto de vista clínico e hormonal 122 pacientes hirsutas. A avaliaçao hormonal incluiu a realizaçao sistemática do teste do ACTH em todas as pacientes. Os dados foram comparados com um grupo controle constituído por 13 mulheres normais, nao hirsutas e com um grupo de 5 heterozigóticas obrigatórias para a deficiência da P45Oc21, maes das pacientes. RESULTADOS: Nove pacientes tiveram o diagnóstico de HAC-NC por déficit na P45O-c21 e 1 por deficiência na P45O-c11. O perfil clínico e hormonal apresentou grande variabilidade entre as 9 pacientes, incluindo os níveis basais de 17-hidroxiprogesterona, que foram normais em 2 delas. A paciente com deficiência na P45O-c11 era normotensa, com acne severa e moderadamente hirsuta, sem outros sinais de virilizaçao. Esta paciente apresentou níveis moderadamente elevados de 17-hidroxiprogesterona em resposta ao ACTH e o diagnóstico foi confirmado pela resposta aumentada do 11 deoxi-cortisol ao estímulo corticotrófico. Na amostra estudada de 122 pacientes hirsutas, a prevalência encontrada para a HAC-NC por deficiência da P45O-c21 foi de 7,4 por cento.

Efecto de la gonadectomía prepuberal en el síndrome de resistencia parcial a los andrógenos / Effect of prepuberal gonadectomy on partial Resitance to Androgens Syndrome

El síndrome de resitencia a los andrógenos es un padecimiento dominante y recesivo ligado a X con manifestaciones clínicas heterogéneas. Se presenta el caso de un paciente de 17 años con amenorrea primaria y abigüedad genital. Tenía el antecedente de hernioplastía inguinal bilateral y probable gonadectomía a los 14 meses de edad. Su cariotipo fue masculino 46, XY y los exámenes hormonales mostraron la existencia de hipogonadismo hipergonadotrópicos. Se descartó la existencia de hiperplasia suprearrenal congénita (deficiencia de 21 hidroxilasa). En el síndrome de resistencia parcial a los andrógenos, la gonadectomía prepuberal evita la virilización progresiva de los genitales externos. Sin embargo, es necesario administrar terapia estrogénica de reemplazo

Características generales y hormonas de la reproducción en la mujer posmenopausica / General characteristics and reproduction hormones of post-menopausal women

Se seleccionó una muestra aleatoria triste de 134 mujeres posmenopáusicas de un área de salud urbana, para conocer algunas características generales, así como las concentraciones de la hormonas de la reproducción (gonadotropinas hipofisarias y sexoesteroides), en este período de la vida. Se determinaron por radioinmunoanálisis las siguientes hormonas : FSH, LH, estradiol (E2), testosterona (T), androstenediona (A'd), prolactina (PRL) y el precursor 17 hidroxiprogesterona (17 OH-P). La edad cronólogica media de las mujeres fue de 56,3 años y un promedio de 8,4 años desde la menopausia. La edad de la menopausia fue 48,1 ñ 4,7 años, fue poco frecuente después de los 55 años (2,2 por ciento) y antes de los 40 (7,5 por ciento); no se presentó ningún caso de menopausia precoz. La obesidad y el hábito de fumar son hallazgos comunes en la mujer posmenopáusica, ambos son factores de riesgo de trastornos de alta prevalencia en estas mujeres como son las cardiopatías isquémicas y la hipertensión arterial, por lo cual se obvia la necesidad de insistir e eliminar o disminuir el riesgo. El patrón de las hormonas de la producción en las mujeres posmenopáusicas se caracterizó por niveles elevados de gonadotropinas (FSH y LH), índice LH/FSH normal, niveles disminuidos de E2 y niveles normales de PRL, 17 OH-P y andrógenos (Ty A'd)

Daily variation of serum cortisol, 17-hydroxyprogesterone and five androgens in healthy women.

Serum cortisol, 17-hydroxyprogesterone and five androgens (androstenedione, 11-hydroxyandrostenedione, dehydroepiandrosterone and its sulphate, and testosterone) were measured by radioimmunoassay at 8:00, 16:00, 20:00 and 24:00 h and again at 8:00 h on the next day in eight healthy female subjects aged 16-40 years in the midfollicular phase of the menstrual cycle. Regression analysis revealed a significant (alpha = 0.05) circadian periodicity, with estimated peaks between 8:00 a.m. (testosterone) and 2:00 p.m. (dehydroepiandrosterone sulphate), and with estimated amplitudes between 76% (11-hydroxyandrostenedione) and 33% (17-hydroxyprogesterone, testosterone and dehydroepiandrosterone sulphate) of the rhythm adjusted mean. The inferential statistical approach illustrated here should contribute significantly to the diagnostic elucidation of adrenocortical disorders.

17 Alfa-Hidroxiprogesterona como marcador de sospecha de hiperplasia adrenal congénita leve y tardía en el síndrome androgénico cutáneo: estudio sobre 84 pacientes / 17-alpha hydroxy-progesterone as a marker for late congenital adrenal hyperplasia (mild form) in the cutaneous androgenic syndrome: a study of 84 patients

Se estudió un grupo de 84 mujeres (promedio de edad 24 años, rango 16 a 37) que consultaron por alguna manifestación del síndrome androgénico cutáneo (75 por ciento acné, 15 por ciento alopecia y 10 por ciento hirsutismo). De este grupo de enfermas, el 54 por ciento presentaba asociado algún tipo de dismenorrea (principalmente oligomenorrea 45 por ciento). Se pudo comprobar que un 52 por ciento de ellas presentaba valores elevados de la 17 alfa-hidroxiprogesterona (x= 1,48 ng/ml), lo cual abrió la sospecha de una hiperplasia adrenal congénica de presentación tardía y leve como causa de androgenismo cutáneo. Este diagnóstico se pudo comprobar en un 7 por ciento por pruebas funcionales, además de haber observado un 8,3 por ciento de poliquistosis ovárica y un 9,5 por ciento de hipotiroidismo

O espectro clínico e laboratorial da forma näo clássica de hiperplasia adrenal congênita por deficiência da 21-hidroxilase / The clinical and laboratorial spectrum of the non-classic way of congenital adrenal hyperplasia by 21-hydroxilase deficiency

Foram estudadas 9 pacientes portadoras da forma nao clássica de hiperplasia adrenal congênita por deficiência de 2l-hidroxilase (2l-FNC). O diagnóstico baseou-se na resposta da 17-hidroxiprogesterona (l7-OHP) 60 minutos após estímulo com 250 ug de ACTH sintético por via EV. Em relaçao à reserva de glicocorticóide, observamos somente uma paciente com resposta deficiente de cortisol ao estímulo com ACTH. A concentraçao basal de 17-OHP foi altamente variável, tanto em relaçao a mesma paciente como entre as pacientes. Em duas delas, observamos concentraçao basal de 17-OHP normal, após estímulo com ACTH, observamos uma hiperresposta de 17-OHP, compatível com o diagnóstico de 2l-FNC. As pacientes foram subdivididas em três grupos de acordo com o diagnóstico clínico: Grupo I: Pubarca precoce (n= 1); Grupo II: Hirsutismo com ciclos menstruais regulares e ovulatórios (n= 4); e Grupo III: Hirsutismo com alteraçao menstrual (n= 3). Nao observamos qualquer diferença entre os três grupos tanto em relaçao à reserva de glicocorticóide adrenal e a concentraçao de 17-OHP, basal ou pós-estímulo, nem com relaçao à parâmetros clínicos, como obesidade, menarca ou idade de início do hirsutismo nas pacientes dos grupos II e III, sugerindo que a manifestaçao clínica da 2l -FNC esteja na dependência de fatores extra-adrenais, excetuando-se a pubarca precoce.

17 Alfa-Hidroxiprogesterona como marcador de sospecha de hiperplasia adrenal congénita leve y tardía en el síndrome androgénico cutáneo: estudio sobre 84 pacientes / 17-alpha hydroxy-progesterone as a marker for late congenital adrenal hyperplasia (mild form) in the cutaneous androgenic syndrome: a study of 84 patients

Se estudió un grupo de 84 mujeres (promedio de edad 24 años, rango 16 a 37) que consultaron por alguna manifestación del síndrome androgénico cutáneo (75 por ciento acné, 15 por ciento alopecia y 10 por ciento hirsutismo). De este grupo de enfermas, el 54 por ciento presentaba asociado algún tipo de dismenorrea (principalmente oligomenorrea 45 por ciento). Se pudo comprobar que un 52 por ciento de ellas presentaba valores elevados de la 17 alfa-hidroxiprogesterona (x= 1,48 ng/ml), lo cual abrió la sospecha de una hiperplasia adrenal congénica de presentación tardía y leve como causa de androgenismo cutáneo. Este diagnóstico se pudo comprobar en un 7 por ciento por pruebas funcionales, además de haber observado un 8,3 por ciento de poliquistosis ovárica y un 9,5 por ciento de hipotiroidismo (AU)

Características generales y hormonas de la reproducción en la mujer posmenopausica / General characteristics and reproduction hormones of post-menopausal women

Se seleccionó una muestra aleatoria triste de 134 mujeres posmenopáusicas de un área de salud urbana, para conocer algunas características generales, así como las concentraciones de la hormonas de la reproducción (gonadotropinas hipofisarias y sexoesteroides), en este período de la vida. Se determinaron por radioinmunoanálisis las siguientes hormonas : FSH, LH, estradiol (E2), testosterona (T), androstenediona (A'd), prolactina (PRL) y el precursor 17 hidroxiprogesterona (17 OH-P). La edad cronólogica media de las mujeres fue de 56,3 años y un promedio de 8,4 años desde la menopausia. La edad de la menopausia fue 48,1 ñ 4,7 años, fue poco frecuente después de los 55 años (2,2 por ciento) y antes de los 40 (7,5 por ciento); no se presentó ningún caso de menopausia precoz. La obesidad y el hábito de fumar son hallazgos comunes en la mujer posmenopáusica, ambos son factores de riesgo de trastornos de alta prevalencia en estas mujeres como son las cardiopatías isquémicas y la hipertensión arterial, por lo cual se obvia la necesidad de insistir e eliminar o disminuir el riesgo. El patrón de las hormonas de la producción en las mujeres posmenopáusicas se caracterizó por niveles elevados de gonadotropinas (FSH y LH), índice LH/FSH normal, niveles disminuidos de E2 y niveles normales de PRL, 17 OH-P y andrógenos (Ty A'd)

[A simplified method in determination of blood 17-hydroxyprogesterone by radioimmunoanalysis]. / Método simplificado para medir 17-OH progesterona plasmática por radioinmunoanálisis.

A practical method to measure 17-OHP, in peripheral blood by radioimmunoanalysis using a highly specific antiserum, is described. The method usefulness described in dependability studies present a sensitivity of the pattern curve of 10 picograms; precision shows a variation rate intranalysis < or = 11.9% and interanalysis of < or = 10.0%. Accuracy was > or = 95% and specificity is demonstrated by antiserum characterization with other steroids. Measuring 17-OHP4 in ng/ml in plasma of women under different physiological conditions, it was found that the levels of this hormone on day -5 of proliferative phase were 0.31 +/- 0.24 nanograms (ng)/ml, and at day +7 of secretory phase of 1.47 +/- 0.65 ng/ml. In patients with stimulation with ACTH show as to the basal sample an increase (double) of levels at 30 minutes, that keeps increasing until 90 minutes with certain trend to diminish at 120 minutes. This study shows that it is possible, to measure 17-OHP4 in human plasma with good dependability degree and easy handling reducing, in addition, operative cost.

Morning steroid profile in children with congenital adrenal hyperplasia under different hydrocortisone schedules.

We studied 13 children with 21-hydroxyalse deficiency to explore the immediate potential suppressive effect of hydrocortisone dose schedule on the adrenal cortex. They were given 20 mg/m2 daily in a controlled trial. After random administration of a greater dose in the morning (7 patients) or at night (6 patients), we measured plasma levels of 17-hydroxyprogesterone, testosterone, and androstenedione at times-24, 0, 2, 4, and 6h. Considerable fluctuation of the steroid levels, unrelated to the drug intake, was observed. There was no statistically significant differences between the "morning dose" and "night dose" groups for any steroid. We conclude that; (i) the greater night dose did not avoid the 17-hydroxyprogesterone morning peaks, and (ii) the variation in plasma steroid levels is so marked that a single morning sample is unreliable to reflect the degree of adrenal suppression.