{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T22:57:14Z","timestamp":1648594634398},"reference-count":119,"publisher":"FapUNIFESP (SciELO)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Bras Endocrinol Metab"],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:p>O tratamento do hipogonadismo hipogonadotr\u00f3fico na mulher adulta com hipopituitarismo inclui diversas alternativas terap\u00eauticas de estr\u00f3genos e progest\u00e1genos, sendo a via oral a de menor custo e a de maior comodidade \u00e0 paciente. A rota estrog\u00eanica oral, entretanto, exerce marcada influ\u00eancia sobre o eixo horm\u00f4nio de crescimento\/fator de crescimento insulina-s\u00edmile n\u00famero 1 (GH\/IGF-1) nessas mulheres. O tratamento com estr\u00f3genos orais, concomitante ao uso de GH em pacientes com hipopituitarismo, antagoniza as a\u00e7\u00f5es biol\u00f3gicas do GH e agrava as anormalidades de composi\u00e7\u00e3o corporal e o metabolismo em geral. Presume-se que o estr\u00f3geno oral iniba a secre\u00e7\u00e3o\/produ\u00e7\u00e3o de IGF-1 por meio de efeito de primeira passagem hep\u00e1tica, causando aumento da secre\u00e7\u00e3o de GH por interm\u00e9dio de inibi\u00e7\u00e3o do feedback negativo de IGF-1 em mulheres normais. Isso \u00e9 demonstrado clinicamente por redu\u00e7\u00e3o da massa magra, aumento da massa gorda, perfil lip\u00eddico aterog\u00eanico e preju\u00edzo do bem-estar psicol\u00f3gico. Alguns estudos apontam que os progest\u00e1genos com a\u00e7\u00e3o androg\u00eanica revertem o efeito de diminui\u00e7\u00e3o dos n\u00edveis s\u00e9ricos de IGF-1 induzida pelos estr\u00f3genos orais. Os progest\u00e1genos neutros n\u00e3o apresentam esse efeito, por\u00e9m, quanto maior a pot\u00eancia androg\u00eanica, maior ser\u00e1 a revers\u00e3o do efeito de diminui\u00e7\u00e3o de IGF-1. Na presente revis\u00e3o da literatura, ser\u00e3o abordados os aspectos cl\u00ednicos da reposi\u00e7\u00e3o com estr\u00f3genos e progest\u00e1genos nas mulheres com hipopituitarismo, suas intera\u00e7\u00f5es nas outras defici\u00eancias hormonais, bem como o impacto do uso de estr\u00f3genos sobre as a\u00e7\u00f5es metab\u00f3licas do GH.<\/jats:p>","DOI":"10.1590\/s0004-27302008000500023","type":"journal-article","created":{"date-parts":[[2008,9,29]],"date-time":"2008-09-29T10:04:16Z","timestamp":1222682656000},"page":"901-916","source":"Crossref","is-referenced-by-count":2,"title":["Influ\u00eancias da reposi\u00e7\u00e3o de estr\u00f3genos e progest\u00e1genos na a\u00e7\u00e3o do horm\u00f4nio de crescimento em mulheres com hipopituitarismo"],"prefix":"10.1590","volume":"52","author":[{"given":"Ana L\u00facia","family":"Isotton","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Celeste O.","family":"Wender","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro A.","family":"Czepielewski","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Sul, Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0140-6736(98)85043-5","article-title":"Pituitary insufficiency","volume":"352","author":"Lamberts SW","year":"1998","journal-title":"Lancet."},{"issue":"3-4","key":"ref2","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1007\/s11102-006-6039-z","article-title":"Diagnosis and treatment of hypopituitarism: an update","volume":"8","author":"van Aken MO","year":"2005","journal-title":"Pituitary","ISSN":"http:\/\/id.crossref.org\/issn\/1386-341X","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0025-6196(12)61397-4","article-title":"Laboratory diagnosis of hypopituitarism","volume":"61","author":"Abboud CF","year":"1986","journal-title":"Mayo Clin Proc."},{"issue":"3","key":"ref4","first-page":"1169","article-title":"The effect of hypopituitarism on life expectancy","volume":"81","author":"Bates AS","year":"1996","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"ref5","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s11102-006-0416-5","article-title":"Hypopituitarism","volume":"9","author":"Ascoli P","year":"2006","journal-title":"Pituitary","ISSN":"http:\/\/id.crossref.org\/issn\/1386-341X","issn-type":"print"},{"issue":"3","key":"ref6","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1210\/jcem-40-3-518","article-title":"Circulating estradiol, estrone and gonadotropin levels following the administration of orally active 17beta-estradiol in postmenopausal women","volume":"40","author":"Yen SS","year":"1975","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"ref7","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/0021-9150(93)90225-J","article-title":"Influence of age and menopause on serum lipids and lipoproteins in healthy women","volume":"98","author":"Stevenson JC","year":"1993","journal-title":"Atherosclerosis."},{"issue":"17","key":"ref8","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1056\/NEJM199110243251702","article-title":"Effects of postmenopausal estrogen replacement on the concentrations and metabolism of plasma lipoproteins","volume":"325","author":"Walsh BW","year":"1991","journal-title":"N Engl J Med."},{"issue":"3","key":"ref9","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1001\/jama.1984.03340270043026","article-title":"The lipid research clinics coronary primary prevention trial results: II. 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