Twenty-four-hour ACTH and cortisol pulsatility in depressed women
Twenty-four-hour ACTH and cortisol pulsatility in depressed women
复制标题
DOI：
10.1016/s0893-133x(00)00236-0
复制
发表时间：
2001-08-01
影响因子：
7.6
通讯作者：
Brown, MB
中科院分区：
文献类型：
--
作者：
Young, EA;Carlson, NE;Brown, MB
重度抑郁症患者血浆皮质醇升高是一个有充分记录的发现，尽管只有25-30%的重度抑郁症患者存在这种情况。然而，ACTH和皮质醇的分泌是搏动的，因此抑郁症中ACTH分泌是否增加以及ACTH分泌的搏动成分是否有变化尚不清楚。对25名年龄和月经周期与对照女性相匹配的绝经前抑郁女性进行24小时的ACTH和皮质醇10分钟采样。作为一个群体，抑郁女性表现出皮质醇分泌增加的趋势（p=0.089）。患者组整体平均皮质醇水平（8.36 +/-2.9马克/分升）与符合非典型抑郁标准的患者（8.38 +/-1.9马克/分升）无差异，但符合内源性抑郁标准的患者皮质醇水平升高（12.17 +/-4马克/分升），患者与对照组的平均ACTH水平无显著差异。脉搏分析显示，患者和对照组皮质醇分泌爆发的分泌事件数量和幅度相似。抑郁症患者皮质醇分泌曲线下基线成分面积呈趋势升高（p = 0.064）， ACTH基线AUC显著升高（p = 0.045）。ACTH的搏动成分在患者和对照组之间没有发现差异。谐波分析表明，在ACTH或皮质醇的任何检测节律上，患者和对照组之间没有显著差异。这些数据表明，绝经前抑郁症妇女HPA轴的脉动和昼夜节律成分是正常的，只有24%的抑郁症妇女表现为高皮质醇血症。[j]中华医学会精神病学分会，2001。Elsevier Science Inc.出版。
Increased plasma cortisol in patients with major depression is a well documented finding, although it is present in only 25-30% of subjects with major depression. However, ACTH and cortisol are secreted in a pulsatile manner, so it is unclear if increased ACTH secretion occurs in depression and if there are changes in the pulsatile components of ACTH secretion. Ten-minute sampling for ACTH and cortisol was performed for 24 hr in 25 premenopausal depressed women, whose age and menstrual cycle day matched control women. As a group, the depressed women demonstrated a trend to increase cortisol secretion (p=0.089). There was no difference in mean cortisol between the patient group as a whole (8.36 +/-2.9 mug/dl) and those patients meeting criteria for atypical depression (8.38 +/-1.9 mug/dl), but patients meeting criteria for endogenous showed increased cortisol (12.17 +/-4 mug/dl) Mean ACTH was not significantly different between patients and controls. Pulse analyses revealed similar number of secretory events and similar amplitudes for cortisol secretory bursts in patients and controls. The baseline component area under the curve of cortisol secretion was increased at a trend level (p =.064) in depressed patients, and the baseline AUC for ACTH was significantly increased in depressed patients (p = .045). No differences were found in pulsatile components of ACTH secretion between patients and matched controls. Harmonic analyses indicated no significant differences between patients and controls on any detected rhythm for ACTH or cortisol. These data suggest that the pulsatile and circadian components of the HPA axis are normal in premenopausal depressed women and that only 24% of depressed women demonstrate hypercortisolemia. [Neuropsychopharmcology 25:267-276,2001] (C) 2001 American College of Neuropsychopharmcology. Published by Elsevier Science Inc.