Serum cortisol concentrations in dogs with pituitary-dependent hyperadrenocorticism and atypical hyperadrenocorticism.
Serum cortisol concentrations in dogs with pituitary-dependent hyperadrenocorticism and atypical hyperadrenocorticism.
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DOI：
10.1111/jvim.12500
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发表时间：
2015-01
影响因子：
2.6
通讯作者：
Rohrbach BW
中科院分区：
文献类型：
--
作者：
Frank LA;Henry GA;Whittemore JC;Enders BD;Mawby DI;Rohrbach BW
非典型肾上腺皮质亢进症（AHAC）是考虑当狗有临床症状的高皮质血症与正常的肾上腺皮质亢进症筛查试验。比较垂体依赖性肾上腺皮质亢进症（PDH）、非典型肾上腺皮质亢进症（AHAC）和健康对照犬的皮质醇浓度和肾上腺大小。10只健康犬，7只PDH犬，8只AHAC犬。研究人员在2011年11月至2013年1月期间对狗进行了前瞻性研究。根据临床症状和筛查试验结果（PDH）阳性或扩展肾上腺激素面板结果（AHAC）异常，诊断为PDH或AHAC。通过腹部超声测量肾上腺横断面。比较三组患者每小时平均皮质醇（9个样本）、每小时皮质醇测量值之和和肾上腺大小。每小时（对照组，1.4±0.6 μg/dL； AHAC, 2.9±1.3；PDH, 4.3±1.5）（mean， SD）和sum（对照组，11.3±3.3；AHAC, 23.2±7.7；PDH, 34.7±9.9）皮质醇浓度在对照组与AHAC组和PDH组之间差异有统计学意义（P < 0.01）。每小时（P < 0.01）皮质醇浓度在AHAC和PDH犬之间存在差异，但在总浓度上没有差异（P = 0.27）。对照组平均肾上腺横径（5.3±1.2 mm）显著小于PDH组（6.4±1.4,P = 0.02）和AHAC组（7.2±1.5,P < 0.01）；肾上腺直径在AHAC和PDH犬之间没有差异（P = 0.18）。与对照组相比，AHAC犬的血清皮质醇浓度升高，但低于PDH犬，而AHAC犬和PDH犬的肾上腺直径相似。这些发现表明皮质醇过量可能有助于AHAC的病理生理。
Atypical hyperadrenocorticism (AHAC) is considered when dogs have clinical signs of hypercortisolemia with normal hyperadrenocorticism screening tests. To compare cortisol concentrations and adrenal gland size among dogs with pituitary‐dependent hyperadrenocorticism (PDH), atypical hyperadrenocorticism (AHAC), and healthy controls. Ten healthy dogs, 7 dogs with PDH, and 8 dogs with AHAC. Dogs were prospectively enrolled between November 2011 and January 2013. Dogs were diagnosed with PDH or AHAC based on clinical signs and positive screening test results (PDH) or abnormal extended adrenal hormone panel results (AHAC). Transverse adrenal gland measurements were obtained by abdominal ultrasound. Hourly mean cortisol (9 samplings), sum of hourly cortisol measurements and adrenal gland sizes were compared among the 3 groups. Hourly (control, 1.4 ± 0.6 μg/dL; AHAC, 2.9 ± 1.3; PDH, 4.3 ± 1.5) (mean, SD) and sum (control, 11.3 ± 3.3; AHAC, 23.2 ± 7.7; PDH, 34.7 ± 9.9) cortisol concentrations differed significantly between the controls and AHAC (P < .01) and PDH (P < .01) groups. Hourly (P < .01) but not sum (P = .27) cortisol concentrations differed between AHAC and PDH dogs. Average transverse adrenal gland diameter of control dogs (5.3 ± 1.2 mm) was significantly less than dogs with PDH (6.4 ± 1.4; P = .02) and AHAC (7.2 ± 1.5; P < .01); adrenal gland diameter did not differ (P = .18) between dogs with AHAC and PDH. Serum cortisol concentrations in dogs with AHAC were increased compared to controls but less than dogs with PDH, while adrenal gland diameter was similar between dogs with AHAC and PDH. These findings suggest cortisol excess could contribute to the pathophysiology of AHAC.