Absence of circadian salivary cortisol rhythm in women with anorexia nervosa
Absence of circadian salivary cortisol rhythm in women with anorexia nervosa
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DOI：
10.1016/j.jpag.2006.10.011
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发表时间：
2007-02-01
影响因子：
1.8
通讯作者：
Silva de Sa, Marcos F.
中科院分区：
文献类型：
--
作者：
dos Santos, Evaldo;dos Santos, Jose E.;Silva de Sa, Marcos F.
研究目的：比较神经性厌食症(AN)患者和正常对照组的皮质醇水平和24小时唾液皮质醇节律。设计：前瞻性横向对照研究。地点：第三转诊大学医院。参与者：25名年龄在15-35岁之间的患者，其中13人有规律排卵周期，12例确诊为AN.干预：唾液和血液采集皮质醇24小时节律测定。主要结果：唾液皮质醇在上午9点、下午5点和晚上11点测定结果：AN患者血清卵泡刺激素、黄体生成素、催乳素、雌二醇、孕酮、脱氢表雄酮-S(脱氢表雄酮-S)和皮质醇水平均低于正常对照组。唾液皮质醇水平与血清皮质醇水平的相关性仅在9 AM样本中观察到(r=0.67，P=0.01；AN：r=0.48，P=0.12)。皮质醇节律在所有对照组受试者中都存在，而在三分之一的患者中没有。保留节律的AN组的曲线下面积显著高于对照组(Me=6811 ng/dl/24 h比3708 ng/dl/24 h；P=0.034)。结论：AN患者的唾液皮质醇水平高于正常女性，部分患者不存在昼夜节律。
Study Objective: To compare the cortisol levels and 24 hour salivary cortisol rhythm in patients with anorexia nervosa (AN) and normal controls.Design: Prospective transversal controlled study.Setting: Tertiary-referral University Hospital.Participants: Twenty-five patients aged 15 to 35 years, 13 of them with regular ovulatory cycles, and 12 with diagnosis of AN.Interventions: Salivary and blood collection for cortisol 24-hour rhythm determination.Main Outcome: Salivary cortisol was determined at 9 Am, 5 Pm, and 11 Pm. Seric follicle-stimulating hormone, luteinizing hormone (LH), prolactin, estradiol (E2), progesterone, dehydroepiandrosterone-S (DHEA-S), and cortisol were sampled together with the 9 AM salivary sample.Results: LH, E2, and DHEA-S levels were reduced in patients with AN. A correlation between salivary and serum cortisol levels was observed in the 9 AM sample only in controls (r = 0.67, P = 0.01; AN: r = 0.48, P = 0.12). Cortisol rhythm was present in all control subjects, whereas it was absent in one third of AN patients. The area under the curve for the AN group with preserved rhythm was significantly higher than for the control group (Me = 6811 ng/dl/24h vs 3708 ng/dl/24 h; P = 0.034).Conclusion: Patients with AN have higher salivary cortisol levels when compared to normal women and some of them do not present circadian rhythm.