Evidence for adrenocortical adaptation to severe illness.
Evidence for adrenocortical adaptation to severe illness.
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肾上腺皮质适应严重疾病的证据。
DOI：
--
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发表时间：
1985
影响因子：
5.8
通讯作者：
Eric T. Lifrak
中科院分区：
文献类型：
--
作者：
Lawrence N. Parker;Ellis R. Levin;Eric T. Lifrak
在严重疾病期间，血清皮质醇浓度和尿皮质醇排泄有特征性增加。在目前的研究中，我们调查了这些糖皮质激素代谢的变化与肾上腺雄激素代谢，测定脱氢表雄酮（DHA）和DHA硫酸盐（DHAS）的RIA。一组23名患有各种疾病的重病男性，患病一周或更长时间，与25名男性对照组年龄匹配，发现以下变化：1）患病组的基础血清皮质醇浓度升高（2）基础血清DHA和DHAS浓度在患病组有降低的趋势基础血清DHA/皮质醇比值和DHAS/皮质醇比值分别下降80.3%和77.2（P <0.001）; 4）ACTH刺激的血清皮质醇浓度在两组中以相同的绝对量增加，而在患病组中刺激的DHA浓度的增加少57.2%。（P <0.05），表明重症患者ACTH刺激的DHA储备存在缺陷; 5）基础每日非结合DHA排泄量在患病组较低（6）基础每日皮质醇排泄量在患病组高于对照组（P <0.05 7）基础每日尿中未结合DHA/皮质醇比值比对照组低85.4%（P <0.001）。最近，Zipser等人描述了重症患者的高肾素性低醛固酮症。他们的研究结果与我们自己的研究结果相结合，表明在严重疾病中肾上腺皮质醇酮的代谢相对转移，远离盐皮质激素和肾上腺雄激素，而转向糖皮质激素。这种变化的原因尚不清楚。我们推测这种相对生化途径优势的转变可能是慢性严重应激期间生存所必需的因素。
During serious illness, there are characteristic increases in serum cortisol concentrations and urinary cortisol excretion. In the present studies, we investigated these changes in glucocorticoid metabolism in relation to adrenal androgen metabolism, as measured by RIA of dehydroepiandrosterone (DHA) and DHA sulfate (DHAS). A group of 23 seriously ill men with various disorders, ill for a week or longer, was age-matched to a control group of 25 men, and the following changes were found: 1) basal serum cortisol concentrations were elevated in the ill group (P less than 0.001), 2) basal serum DHA and DHAS concentrations tended to be lower in the ill group (P less than 0.1); 3) basal serum DHA to cortisol and DHAS to cortisol ratios were decreased in the ill group by 80.3% and 77.2%, respectively (P less than 0.001); 4) ACTH-stimulated serum cortisol concentrations increased by the same absolute amount in both groups, whereas the increase in stimulated DHA concentrations in the ill group was 57.2% less (P less than 0.05), indicating a defect in ACTH-stimulated DHA reserve in serious illness; 5) basal daily unconjugated DHA excretion was lower in the ill group (P less than 0.05); (6) basal daily cortisol excretion was higher in the ill group (P less than 0.05); and 7) the basal daily urinary unconjugated DHA to cortisol ratio was 85.4% lower in the ill group (P less than 0.001). Recently, Zipser et al. described the entity of hyperreninemic hypoaldosteronism in the seriously ill. Their findings combined with our own indicate a relative shift in the metabolism of adrenal pregnenolone in serious illness away from mineralocorticoids and adrenal androgens and toward glucocorticoids. The cause of this change is unknown. We speculate that this shift of relative biochemical pathway predominance may be a factor necessary for survival during chronic severe stress.
非甲状腺疾病患者血清中存在抑制固体基质、血清蛋白和大鼠肝细胞与碘甲状腺原氨酸结合的因子的证据。
DOI：
10.1210/jcem-54-4-757
发表时间：
1982
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Oppenheimer,JH;Schwartz,HL;Mariash,CN;Kaiser,FE
通讯作者：
Kaiser,FE
甲状腺激素与血清蛋白结合的抑制剂存在于甲状腺外组织中。
DOI：
10.1126/science.7058324
发表时间：
1982
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Chopra,IJ;Solomon,DH;Teco,GN;Eisenberg,JB
通讯作者：
Eisenberg,JB
影响因子：
15.9
作者：
KAPTEIN, EM;ROBINSON, WJ;NICOLOFF, JT
通讯作者：
NICOLOFF, JT