Adrenomedullary, adrenocortical, and sympathoneural responses to stressors: a meta-analysis.
Adrenomedullary, adrenocortical, and sympathoneural responses to stressors: a meta-analysis.
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发表时间：
2008-09
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通讯作者：
D. Goldstein;I. Kopin
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作者：
D. Goldstein;I. Kopin
目的 暴露于压力源会改变肾上腺髓质激素系统 (AHS)、下丘脑-垂体-肾上腺皮质 (HPA) 轴和交感神经系统 (SNS) 的活动。在这里，我们报告了文献荟萃分析的结果，检查了 AHS、HPA 和 SNS 对应激源的反应之间的相互关系，通过血浆肾上腺素 (EPI)、促肾上腺皮质激素 (ACTH) 和去甲肾上腺素 (NE) 水平进行测量。方法 通过 PubMed 搜索筛选医学科学文献，检索描述暴露于压力源之前、期间或之后测量的血浆 EPI、ACTH 和 NE 水平原始数据的出版物。反应程度的分级从 0 分（无反应）到 4 分（大幅增加到>或=基线值的 10 倍）。结果 总共确定了 15 种压力源，至少有 2 篇出版物报告了 EPI、ACTH 和 NE 反应的数据。共收录60份报告。平均 EPI 反应与平均 ACTH 反应呈强正相关 (r=0.93)，与 NE 反应呈不太强的正相关 (r=0.40)。低血糖期间血浆 EPI 反应不成比例地大于 NE 反应，而在没有低温、直立性和主动逃避/避免的冷暴露期间小于 NE 反应。在没有低温和剧烈/疲惫运动的寒冷暴露期间，血浆 NE 反应不成比例地大于 ACTH 反应，而在低血糖期间小于 ACTH 反应。讨论 这项荟萃分析的结果表明，肾上腺髓质和下丘脑-垂体-肾上腺皮质对各种应激源的反应之间存在密切关联。这种关联似乎比肾上腺髓质和交感去甲肾上腺素反应之间的关联更强烈。
OBJECTIVE Exposure to stressors alters activities of the adrenomedullary hormonal system (AHS), hypothalamic-pituitary-adrenocortical (HPA) axis, and sympathetic nervous system (SNS). Here we report results of a meta-analysis of the literature, examining inter-relationships among AHS, HPA, and SNS responses to stressors, as measured by plasma epinephrine (EPI), corticotrophin (ACTH), and norepinephrine (NE) levels. METHODS The medical scientific literature was culled by PubMed searches, to retrieve publications describing original data about plasma EPI, ACTH, and NE levels measured before and during or after exposure to stressors. Magnitudes of responses were graded from a score of 0 for no response to 4 for a massive increase to >or=10 times the baseline value. RESULTS A total of 15 stressors were identified for which at least 2 publications reported data for EPI, ACTH, and NE responses. A total of 60 reports were included. Mean EPI responses were strongly positively correlated with mean ACTH responses (r=0.93) and less strongly with NE responses (r=0.40). Plasma EPI responses were disproportionately larger than NE responses during hypoglycemia and smaller than NE responses during cold exposure without hypothermia, orthostasis, and active escape/avoidance. Plasma NE responses were disproportionately larger than ACTH responses during cold exposure without hypothermia and severe/exhausting exercise and smaller than ACTH responses during hypoglycemia. DISCUSSION The results of this meta-analysis indicate a close association between adrenomedullary and hypothalamic-pituitary-adrenocortical responses across a variety of stressors. This association seems to be if anything stronger than that between adrenomedullary and sympathetic noradrenergic responses.