Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia
Hyposecretion of adrenal androgens and the relation of serum adrenal steroids, serotonin and insulin-like growth factor-1 to clinical features in women with fibromyalgia
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DOI：
10.1016/s0304-3959(99)00113-x
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发表时间：
1999-11-01
期刊：
影响因子：
7.4
通讯作者：
Van der Merwe, BA
中科院分区：
文献类型：
--
作者：
Dessein, PH;Shipton, EA;Van der Merwe, BA
神经内分泌缺陷与纤维肌痛（FM）有关。在本研究中，肾上腺雄激素代谢产物及其与FM的健康状况的关系进行了调查。为了比较，其他相关的神经内分泌介质的血清水平与健康状况相关。连续57名FM女性完成了纤维肌痛影响问卷（FIQ）。空腹取血测定硫酸脱氢表雄酮（DHEAS）、游离睾酮（T）、皮质醇、5-羟色胺和胰岛素样生长因子-1。114例健康人DHEAS、T正常值。DHEAS水平在绝经前和绝经后均显著降低（P < 0.0001和P < 0.0005）。T水平在绝经前显著降低，绝经后无显著性差异（P> 0.0001和P = 0.06）。神经激素水平和FIQ评分之间存在以下相关性：DHEAS（年龄调整后）与疼痛（P < 0.001）和T（年龄调整后）与身体功能（P = 0.002）。其他神经激素水平均与FIQ评分无显著相关性。肥胖组IGF-1水平低于非肥胖组（P = 0.03）。BMI与疼痛呈正相关（P < 0.001），与DHEAS水平呈负相关（P = 0.006）。在进一步调整BMI后，年龄调整后的DHEAS和疼痛之间的相关性不再显著。在FM中记录了肾上腺雄激素分泌不足。这在肥胖患者中更为明显。低血清雄激素水平与FM的健康状况不佳相关。需要进行纵向研究，以阐明这些是否是因果关系。(C)1999年国际疼痛研究协会。出版社：Elsevier Science B. V.
Neuroendocrine deficiencies have been implicated in fibromyalgia (FM). In the present study, adrenal androgen metabolites and their relationship with health status in FM were investigated. For comparison, serum levels of other implicated neuroendocrine mediators were correlated with health status. Fifty-seven consecutive women with FM completed the Fibromyalgia Impact Questionnaire (FIQ). Fasting blood samples were taken for measurement of dehydroepiandrosterone sulphate (DHEAS), free testosterone (T), cortisol, serotonin and insulin-like growth factor-1. Normal value for DHEAS and T were obtained from 114 controls. DHEAS levels were decreased significantly in pre- and postmenopausal patients (P < 0.0001 and P < 0.0005, respectively). T levels were decreased significantly in premenopausal and insignificantly in postmenopausal patients (P < 0.0001 and P = 0.06, respectively). The following correlations between neurohormonal levels and FIQ scores were found: DHEAS (after adjustment for age) vs. pain (P < 0.001) and T (after adjustment for age) versus physical functioning (P = 0.002). None of the other neurohormonal levels correlated significantly with any of the FIQ scores. IGF-1 levels were lower in the obese patients as compared to those who were non-obese (P = 0.03). The BMI correlated positively with pain (P < 0.001) and inversely with DHEAS levels (P = 0.006). After further adjustment for BMI, the correlation between age adjusted DHEAS and pain was no longer significant. Hyposecretion of adrenal androgens was documented in FM. This was more pronounced in obese patients. Low serum androgen levels correlated with poor health status in FM. Longitudinal studies are needed to elucidate whether these are cause and/or effect relationships. (C) 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.