Diurnal rhythm of plasma catecholamines in acromegaly
Diurnal rhythm of plasma catecholamines in acromegaly
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DOI：
10.1210/jc.84.7.2458
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发表时间：
1999-07-01
影响因子：
5.8
通讯作者：
degli Uberti, E
中科院分区：
文献类型：
--
作者：
Bondanelli, M;Ambrosio, MR;degli Uberti, E
我们研究了14例肢端肥大症患者经蝶窦手术前（A）和手术后3-6个月（C-R，治愈; A-A，活动）以及8例年龄匹配的正常受试者（N）的24小时循环去甲肾上腺素（NE）和肾上腺素（E）水平、血压（BP）和心率。此外，NE，E，PRA和醛固酮的反应，直立姿势进行了研究。在肢端肥大症组和N组受试者之间，平均24-B血浆NE和E水平没有显著差异。24小时曲线的分析表明，在N受试者中NE和E的24小时节律具有统计学显著性。A组血浆NE、E和BP无24小时节律。手术后，峰值相患者的NE 24小时节律具有统计学意义（C-A和A-A患者分别为13.54和13.45 h）和中位（C-A和A-A患者分别为1019.8 +/- 45.1和1017.8 +/- 54.7 pmol/L），与N受试者中观察到的结果相似（顶相，13.21 h;中相，942.3 +/- 42.5 pmol/L）。手术后，在C-A和A-A患者中，E的血浆浓度在24小时内明显波动，即使余弦分析未能显示24小时的显著节律。仅在C-A患者中恢复了具有统计学意义的24小时血压节律。平均24小时心率A组略高于N组，但差异有统计学意义（P < 0.05），术后有所下降。各组肢端肥大症患者和N组受试者之间在直立刺激NE、E和血浆醛固酮水平方面无显著差异。然而，基础和垂直刺激PRA水平显着（P < 0.001）较低的A patients.In结论，我们的研究表明，缺乏一个明确的昼夜变化，儿茶酚胺水平和BP活动性肢端肥大症和一个显着的24小时节律的NE和BP垂体手术后的回报，伴随着GH和胰岛素样生长因子I血清水平的降低。
We investigated the 24-h profiles of the circulating levels of norepinephrine (NE) and epinephrine (E), blood pressure (BP), and heart rate in 14 acromegalic patients, before (A) and 3-6 months after transsphenoidal surgery (C-R, cured; A-A, active), and in 8 age-matched normal subjects (N). In addition, the responses of NE, E, PRA, and aldosterone to upright posture were investigated. No significant differences in the mean 24-b plasma NE and E levels were observed between either group of acromegalics and the N subjects. Analysis of the 24-h profiles indicated a statistically significant 24-h rhythm of both NE and E in N subjects. No evidence of a 24-h rhythm of plasma NE and E and BP was found in A patients. After surgery, a statistically significant 24-h rhythm of NE was detected in the patients with acrophase (13.54 and 13.45 h in C-A and A-A patients, respectively) and mesor (1019.8 +/- 45.1 and 1017.8 +/- 54.7 pmol/L in C-A and A-A patients, respectively) similar to those observed in N subjects (acrophase, 13.21 h; mesor, 942.3 +/- 42.5 pmol/L). After surgery, the plasma concentration of E clearly fluctuated throughout the 24 h in both C-A and A-A patients, even if cosinor analysis failed to reveal a 24-h significant rhythm. A statistically significant 24-h rhythm of BP was restored only in C-A patients. The mean 24-h heart rate was slightly, but significantly (P < 0.05), higher in A than in N subjects and decreased after surgery. No significant differences in upright-stimulated NE, E, and plasma aldosterone levels were observed between each group of acromegalics and N subjects. However, basal and upright-stimulated PRA levels were significantly (P < 0.001) lower in A patients.In conclusion, our study demonstrates the lack of a clear circadian variation in catecholamine levels and BP in active acromegaly and the return of a significant 24-h rhythm of NE and BP after pituitary surgery, concomitant with the reduction in GH and insulin-like growth factor I serum levels.