The correlation between neurosteroids and neurotransmitters with liver yang rising and liver qi stagnation types of premenstrual syndrome

Abstract

Background: To investigate neural-reproductive hormonal basis of liver yang rising (LYR), liver qi stagnation (LQS) premenstrual syndrome (PMS), and to develop standardized diagnostic criteria for PMS.

Methods: HPLC, HPLC-MC, ELISA and radioimmunoassay were used to compare levels of serum hormones, plasma neurotransmitters and neurosteroids between LYR PMS patients, LQS PMS patients and healthy controls (30 subjects in each group).

Results: Of the measures, all three groups exhibited no significant differences during the follicular phase. In contrast, during the luteal phase, LYR PMS testosterone levels tended to be higher than controls, while dopamine and 5-HT of the LYR PMS group were significantly higher. Conversely, γ-aminobutyric acid in the LYR PMS group was significantly lower than controls (p < 0.05). On the other hand, epinephrine and norepinephrine levels in both PMS groups were significantly higher than controls (p < 0.05), while pregnenolone and allopregnanolone of LYR and LQS groups were significantly lower than controls, with dehydroepiandrosterone (DHEA) being significantly higher than controls (p < 0.05). The ratios of DHEA/allopregnanolone and DHEA/pregnenolone of both PMS groups were significantly higher than the control group, with the LYR PMS group ratios being significantly higher than in the LQS PMS group (p < 0.05).

Conclusion: The decrease in pregnenolone and allopregnenolone, increase in DHEA, DHEA/allopregnanolone and DHEA/pregnenolone during the luteal phase may be one of the biological bases for anger in LYR PMS patients and depression in LQS PMS patients.

Chinese abstract

背景：研究肝阳上升（liver yang rising，LYR）、肝气郁结型（liver qi stagnation，LQS）经前期综合征的神经源性激素生成基础，并为经前期综合征建立标准化诊断标准。

方法：应用高效液相色谱（HPLC）、高效液相-质谱联用（HPLC-MC）、酶联免疫吸附测定（enzyme-linked immuno sorbent assay，ELISA）、放射免疫检定法测定肝阳上升型经前期综合征（LYR PMS）患者、肝气郁结型经前期综合征（LQS PMS）患者、健康对照人群血清激素、神经递质和神经甾体水平，每组30例。

结果：不同检测方法，三个研究组之间卵泡期均无统计学差异；但黄体期LYR PMS组睾酮水平有高于对照组的趋势，多巴胺和5-羟色胺显著增高。相反地，LYR PMS组的γ-氨基丁酸显著低于对照组（p﹤0.05）。另一方面，两型经前期综合征组的肾上腺素水平及去甲肾上腺素水平显著高于对照组（p﹤0.05），而孕烯醇酮和别孕烯醇酮水平显著低于对照组，脱氢表雄酮（DHEA）显著高于对照组（p﹤0.05）。两型经前期综合征组的DHEA/别孕烯醇酮比值、DHEA/孕烯醇酮比值显著高于对照组，且LYR PMS组显著高于LQS PMS组 （p﹤0.05）。

结论：黄体期孕烯醇酮和别孕烯醇酮水平降低，DHEA 水平、DHEA/别孕烯醇酮比值、DHEA/孕烯醇酮比值升高可能是肝阳上升型经前期综合征患者易怒及肝气郁结型经前期综合征患者情绪低落的生物学基础。

• Liver qi stagnation
• liver yang rising
• neurosteroids
• neurotransmitters
• premenstrual syndrome
• sex hormone levels