Insulin hypoglycemia suppresses TSH secretion in man: studies with an immunoradiometric TSH assay.
Insulin hypoglycemia suppresses TSH secretion in man: studies with an immunoradiometric TSH assay.
复制标题
胰岛素低血糖抑制人类 TSH 分泌：免疫放射 TSH 测定研究。
DOI：
10.1055/s-2007-1012234
复制
发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Jackson,IM
中科院分区：
文献类型：
--
作者：
Lamberton,RP;Cobb,WE;Jackson,IM
方法6名正常志愿者（男5名，女1名，年龄25-34岁）（研究方案由新英格兰医学中心人体调查审查委员会批准）。在研究的第1天，每30分钟对血液进行TSH和皮质醇采样，持续24小时。在第2天，进行标准胰岛素耐受性试验。采集血液用于基线血清TSH和皮质醇测定（时间0），并IV注射常规胰岛素（0.1单位/kg BWT）。然后在以下时间采血用于血清葡萄糖、TSH和皮质醇：时间15分钟、30分钟、45分钟、60分钟、90分钟、120分钟和240分钟。所有受试者在胰岛素给药后均出现症状性低血糖（血糖< 45 mg%）。在测定皮质醇和TSH之前，将血清冷冻储存（-20 ℃）。使用Serono Diagnostics，Randolf，MA开发的免疫放射测定法测定TSH水平（灵敏度0.1-0.2 μ U/ml; Cobb，兰伯顿和杰克逊（1984）先前已发表了关于测定法精密度的其他详细信息。通过竞争性蛋白结合技术测定血清皮质醇。每名受试者的所有样本均在相同的TSH和皮质醇测定中一式两份运行。为了确定胰岛素诱导的低血糖对TSH的影响，我们计算了TSH分泌指数，即综合TSH反应。该指数表示为uUTSH/min/ml，基于基线（时间0）TSH浓度与胰岛素给药后后续TSH浓度之间的积分面积。用配对学生t检验（双尾）分析结果，并将显著性定义为P< 0.05水平。使用线性回归方程（Y= A+ BX）（XAMFO软件程序）进行血清皮质醇和TSH之间的相关性。
MethodsSix normal volunteers (5 male, 1 female ages 25-34) were studied (protocol approved by the Human Investigation Review Committee, New England Medical Center). On day 1 of the study, blood was sampled for TSH and Cortisol every 30 minutes for 24 hours. On day 2 a standard insulin tolerance test was performed. Blood was sampled for baseline serum TSH and Cortisol determinations (time 0) and regular insulin (0.1 units per kg BWT) was injected IV. Blood was then withdrawn at the following times for serum glucose, TSH and Cortisol: time 15', 30', 45', 60', 90', 120', and 240 minutes. Symptomatic hypoglycemia developed in all subjects following insulin administration (glucose< 45 mg%). The serum was stored frozen (—20 C) prior to assay for Cortisol and TSH. An immunoradiometric assay developed by Serono Diagnostics, Randolf, MA was used to determine TSH levels (sensitivity 0.1-0.2 ulU/ml; additional details on the assay precision have been previously published by Cobb, Lamberton and Jackson (1984). Serum Cortisol was assayed by a competitive protein binding technique. All samples for each subject were run in duplicate in the same TSH and Cortisol assays. In order to determine the effect of insulin induced hypoglycemia on TSH we calculated an index of TSH secretion, the integrated TSH response. This index, expressed as uUTSH/min/ml, is based on the integrated area between the baseline (time 0) TSH concentration and the subsequent TSH concentrations following insulin. The results were analyzed with the paired student's t-test (two-tailed) and significance was defined at the P< 0.05 level. Correlations between serum Cortisol and TSH were performed using a linear regression equation (Y= A+ BX)(CLINFO software program).