Differential menstrual cycle regulation of hypothalamic-pituitary-adrenal axis in women with premenstrual syndrome and controls.
Differential menstrual cycle regulation of hypothalamic-pituitary-adrenal axis in women with premenstrual syndrome and controls.
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DOI：
10.1210/jc.2002-021570
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发表时间：
2003-07
期刊：
影响因子：
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通讯作者：
C. Roca;P. Schmidt;M. Altemus;P. Deuster;M. Danaceau;K. Putnam;D. Rubinow
中科院分区：
文献类型：
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作者：
C. Roca;P. Schmidt;M. Altemus;P. Deuster;M. Danaceau;K. Putnam;D. Rubinow
以前的动物研究表明，生殖类固醇是下丘脑-垂体-肾上腺（HPA）轴的有效调节剂，HPA轴是一种在情感障碍（如重度抑郁症）中通常失调的生理系统。生殖类固醇激素在人类HPA轴调节中的作用的确定是重要的，当试图了解经前综合征（PMS）的病理生理学，月经周期的黄体期的情感症状为特征的障碍。我们进行了两项研究，使用跑步机运动负荷试验，以确定月经周期阶段和诊断的影响下丘脑-垂体-肾上腺轴的妇女与PMS和控制和性腺类固醇激素的作用下丘脑-垂体-肾上腺轴的调制在控制妇女。这些研究的结果表明，经前综合征的妇女未能显示正常的增加HPA轴的反应，在黄体期的运动和孕激素，而不是雌二醇，产生增加HPA轴的反应，在控制妇女的跑步机压力测试。这些数据表明，经前综合征的妇女，当有症状时，似乎有一个异常的反应，孕酮，此外，不显示HPA轴异常的特征性抑郁症。
Previous studies in animals indicate that reproductive steroids are potent modulators of the hypothalamic-pituitary-adrenal (HPA) axis, a physiologic system that is typically dysregulated in affective disorders, such as major depression. Determination of the role of reproductive steroids in HPA axis regulation in humans is of importance when attempting to understand the pathophysiology of premenstrual syndrome (PMS), a disorder characterized by affective symptoms during the luteal phase of the menstrual cycle. We performed two studies using treadmill exercise stress testing to determine the effect of menstrual cycle phase and diagnosis on the HPA axis in women with PMS and controls and the role of gonadal steroids in HPA axis modulation in control women. The results of these studies indicate that women with PMS fail to show the normal increased HPA axis response to exercise during the luteal phase and that progesterone, not estradiol, produces increased HPA axis response to treadmill stress testing in control women. These data demonstrate that women with PMS, when symptomatic, appear to have an abnormal response to progesterone and, furthermore, do not display the HPA axis abnormalities characteristic of major depression.