SEX HORMONE REPLACEMENT THERAPY AND ADOLESCENT BEHAVIOR

性激素替代疗法和青少年行为

• 批准号: 3328154
• 负责人: HOWARD E KULIN
• 金额: $ 20.16万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-06-01 至 1995-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3328154
• 关键词: Kallmann's syndrome; Klinefelter's syndrome; Turner's syndrome; adolescence (12-20); androgens; automated data processing; behavior; behavior test; blood chemistry; cognition; drug administration rate /duration; emotional adjustment; emotions; estrogens; female; human puberty; human subject; human therapy evaluation; hypogonadism; longitudinal human study; male; perception; placebos; questionnaires; radioimmunoassay; self concept; sex behavior; sex development disorder; sex hormones; steroid hormone; testosterone; urinalysis

DESCRIPTION: (Adapted From The Applicant's Abstract) The second decade of life involves phenomenal changes in hormone levels, growth, body habitus, and behavior. It has been axiomatic that these perturbations are connected, but few investigations have been able to address the issue of behavioral causation during human puberty. A central issue is whether increases in hormone levels directly influence the brain with resultant behavioral effects or whether the adolescent's perception of his/her secondary sex characteristics provide the major basis for behavioral change? The crucial experimental method for establishing a causal role for a hormone by removal of the secretory source and then replacing the endocrine material to be studied has not been applied to behavioral investigations during adolescence. The present proposal will attempt to determine the direct influence of sex hormones on the brain by performing sequential behavior testing in more than 50 sex steroid-deficient adolescents between the ages of 11 and 17 before, during, and after they receive therapeutic hormone replacement therapy. Boys and girls with primary or secondary hypogonadism will be given low, intermediate, and higher physiologic dosage amounts of either testosterone or estrogen, alternating with placebo, over 3-month periods, following established regimes. Intramuscular testosterone enanthate will be administered to boys and oral, conjugated estrogens to girls. The low dosage of sex steroids will approximate the normal, early pubertal hormone milieu and will be furnished in a randomized, double-blind, cross-over design. Intermediate levels of androgen and estrogen will approximate the mid-pubertal sex hormone environment, and the high dose will approximate late pubertal amounts of hormone. Over an 18-21 month period the participants will be tested 7 or 8 times in behavioral domains which include cognition, emotions and behavior problems, sexuality and self-perception, and parental perceptions of emotions and behavior problems. Gender-specific data analysis will direct major attention to longitudinal comparisons of changes in behavior assessed during hormone-replete and hormone-depleted periods. Differences between how androgens affect male behavior and estrogens impinge upon female behavior during adolescence also will be examined. The proposed 3-year, longitudinal study has the potential for making a major advance in explaining how sex steroids in varying doses affect behavior during the pubertal period. Such information will be useful in designing intervention strategies for improved health care to adolescents.

描述：（改编自申请人的摘要）第二个十年 生命涉及激素水平、生长、身体习惯的显着变化， 和行为。 不言而喻的是，这些扰动是 相关，但很少有调查能够解决这个问题 人类青春期的行为因果关系。 一个核心问题是是否 激素水平的增加直接影响大脑，从而产生 行为影响或青少年对自己的看法 第二性征是行为的主要基础 改变？ 建立因果关系的关键实验方法 通过去除分泌源然后更换激素 待研究的内分泌材料尚未应用于行为 青春期期间的调查。 本提案将试图确定性别的直接影响 通过在更多的环境中进行连续行为测试来检测大脑中的激素 超过 50 名 11 至 17 岁之间缺乏性类固醇的青少年 在接受治疗性激素替代治疗之前、期间和之后 治疗。 患有原发性或继发性性腺功能减退症的男孩和女孩将 给予低、中、高生理剂量 睾酮或雌激素与安慰剂交替使用，为期 3 个月， 遵循既定制度。 肌肉注射庚酸睾酮会 男孩可口服结合雌激素，女孩可口服结合雌激素。 低 性类固醇的剂量将接近正常的青春期早期激素 环境并将以随机、双盲、交叉的方式提供 设计。 雄激素和雌激素的中等水平将接近 青春期中期的性激素环境，高剂量将接近 青春期后期的激素量。 在 18-21 个月期间 参与者将在行为领域接受 7 或 8 次测试 包括认知、情绪和行为问题、性和 自我认知以及父母对情绪和行为的认知 问题。 针对特定性别的数据分析将主要关注 期间评估的行为变化的纵向比较 激素充足期和激素缺乏期。 方式之间的差异 雄激素影响男性行为，雌激素影响女性行为 青春期期间也会接受检查。 拟议的3年， 纵向研究有可能在以下方面取得重大进展： 解释不同剂量的性类固醇如何影响行为 青春期。 这些信息将有助于设计干预措施 改善青少年卫生保健的战略。