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doi: 10.1016/S1575-0922(07)71415-8
Puesta al día: pruebas de laboratorio en Endocrinología y Nutrición
Gonadotropinas (LH y FSH) y corticotropina (ACTH)
Gonadotropins (LH and FSH) and adrenocorticotropin (ACHT)
Neus Potau Vilalta, Ana Carreño de Puig,
Laboratorio Hormonal. Hospital Materno-Infantil Vall d’Hebron. Barcelona. España
Received 12 July 2006, Accepted 12 October 2006
Abstract

Las gonadotropinas (LH y FSH) y la corticotropina (ACTH) son hormonas hipofisarias reguladas por los factores hipotalámicos correspondientes. Las gonadotropinas regulan la función gonadal masculina y femenina, así como la síntesis de las hormonas sexuales. Su cuantificación se realiza por inmunoanálisis tanto basal como en respuesta a estímulos de análogos de la Gn-RH. Su estudio es útil en el diagnóstico de la pubertad precoz, en los hipogonadismos y en las diversas afecciones del eje hipotálamo-hipofiso-gonadal.

La corticotropina es otro péptido de origen hipofisario que ejerce su acción sobre la corteza suprarrenal estimulando la esteroidogénesis. Se secreta de forma pulsátil y presenta un ritmo circadiano característico, con un máximo de secreción por la mañana. La corta vida media, su inestabilidad, los tratamientos con corticoides y su vulnerabilidad a las enzimas celulares son factores a tener en cuenta en su valoración. Su cuantificación en plasma se realiza por inmunoanálisis, y su derivado sintético (ACTH 1-24) se utiliza como estímulo farmacológico para el estudio de la función hipotálamo-hipofiso-suprarrenal. Aunque el test de referencia es la hipoglucemia insulínica, por sus dificultades y contraindicaciones el test de estimulación con ACTH 1-24 se considera un método indirecto de detección de las alteraciones hipotálamohipofisarias. También ha sido utilizado para valorar la actividad enzimática suprarrenal y sus alteraciones congénitas, como la hiperplasia suprarrenal congénita (HSC) o adquirida.

La participación del laboratorio hormonal es de gran utilidad en el diagnóstico de las enfermedades que afectan a dichos péptidos.

Abstract

Gonadotropins (LH and FSH) and adrenocorticotropin (ACTH) are pituitary hormones regulated by the corresponding hypothalamic releasing factors.

Gonadotropins are the main regulators of male and female gonadal functions and sexual hormone synthesis. Laboratory assessment of LH and FSH can be basal or stimulated by GnRH analogs, using immunoassay methods. In precocious puberty, hypogonadism or other pathological conditions affecting hypothalamic-pituitary-gonadal axis, LH and FSH measurement are useful and sensitive alone or together with sexual hormones (testosterone and estradiol) in order to establish the diagnosis.

Corticotropin (ACTH) is another pituitary hormone which regulates adrenal steroid synthesis. Hormone release is pulsatil throughout the day, but exhibits a diurnal pattern with levels being the highest in the early morning. ACTH secretion increases in response to hypocortisolemia if the hypothalamus and pituitary gland are intact. Numerous factors affect interpretation of the ACTH test, including half-life, stability, glucocorticoid administration and vulnerability to cellular enzymes all of which must be taken into account. Immunoassay methods are reliable and different tests can be used to study hypothalamic-pituitary-adrenal axis secondary to deficiency or hyperfunction.

Hormonal laboratory assessment has a valuable role to establish the diagnosis of the diseases affecting these peptides.

Palabras clave
Gonadotropinas, Lutropina, Folitropina, Corticotropina, Análogos de la gonadoliberina
Key words
Gonadotropins, Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Corticotropin (ACTH), Gn-RH analogs
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Correspondencia: Dra. A. Carreño de Puig. Laboratorios Clínicos. Hospital Vall d’Hebron. C/ Pg. Vall d’Hebron, 129. 08035 Barcelona. España.
Copyright © 2007. Sociedad Española de Endocrinología y Nutrición