RESPONSES OF PLASMA ADRENOCORTICAL STEROIDS TO LOW-DOSE ACTH IN NORMAL SUBJECTS
RESPONSES OF PLASMA ADRENOCORTICAL STEROIDS TO LOW-DOSE ACTH IN NORMAL SUBJECTS
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DOI：
10.1111/j.1365-2265.1995.tb02037.x
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发表时间：
1995-09-01
影响因子：
3.2
通讯作者：
YASUDA, K
中科院分区：
文献类型：
--
作者：
DAIDOH, H;MORITA, H;YASUDA, K
目的临床使用的标准促肾上腺皮质激素(ACTH)试验采用药理剂量的ACTH来评估肾上腺皮质的最大分泌能力。我们研究了血浆肾上腺皮质类固醇激素包括皮质醇、醛固酮和脱氢表雄酮(DHEA)对ACTH生理剂量(ACTH1-24、四环素、皮质酮)的反应，确定了在不同生理剂量(0.1、0.5、1和5 mU g)和标准药理剂量(250 MU G)下进行ACTH快速反应的最小剂量。结果各激素对ACTH的生理剂量均有剂量依赖性反应。皮质醇和脱氢表雄酮的峰值和增量值的最小剂量为0.5mg，而醛固酮的最小剂量为0.1mg，各激素的达峰时间随剂量的增加而推迟。在1~5mU g和0.5~5mU g ACTH试验中，血浆醛固酮和DHEA的峰值时间明显早于血浆皮质醇。结论ACTH对生理剂量的敏感性由大到小依次为：醛固酮和DHEA=皮质醇。当使用峰值和增量时，在快速ACTH试验中，足够的ACTH剂量为：血浆醛固酮0.1微克，血浆皮质醇和脱氢表雄酮0.5微克。
OBJECTIVE The standard ACTH test in clinical use employs a pharmacological dose of ACTH which assesses the maximum secretory capacity of the adrenal cortex. We have investigated the responses of plasma adrenocortical steroids including cortisol, aldosterone and dehydroepiandrosterone (DHEA) to physiological doses of ACTH (ACTH 1-24, tetracosactide, Cortrosyn) and determined the minimal dose which induces a response equivalent to that induced by a pharmacological dose of ACTH.DESIGN Rapid ACTH tests at various physiological (0.1, 0.5 , 1 and 5 mu g) and standard pharmacological (250 mu g) intravenous doses.SUBJECTS Seven healthy normal volunteers.MEASUREMENTS Plasma cortisol, aldosterone and DHEA were measured. Peak value and the increment from basal value were used as indices of responses.RESULTS Each steroid responded to physiological doses of ACTH in a dose dependent manner. The minimum dose inducing an equivalent response to 250 mu g ACTH was 0.5 mu g for peak and incremental values in cortisol and DHEA, while that for aldosterone was 0.1 mu g The time to peak for each steroid was delayed as the dose increased. Plasma aldosterone and DHEA peaked significantly earlier than plasma cortisol in 1-5 mu g and 0.5-5 mu g ACTH tests, respectively.CONCLUSIONS These results suggest that the sensitivity of secretion to physiological doses of ACTH in descending order is aldosterone > DHEA=cortisol. When peak and incremental values are used, sufficient doses of ACTH are 0.1 mu g for plasma aldosterone and 0.5 mu g for plasma cortisol and DHEA in the rapid ACTH test.