HYPOTHALAMIC-PITUITARY-ADRENAL AXIS PERTURBATIONS IN PATIENTS WITH FIBROMYALGIA
HYPOTHALAMIC-PITUITARY-ADRENAL AXIS PERTURBATIONS IN PATIENTS WITH FIBROMYALGIA
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DOI：
10.1002/art.1780371105
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发表时间：
1994-11-01
影响因子：
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通讯作者：
WILDER, RL
中科院分区：
文献类型：
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作者：
CROFFORD, LJ;PILLEMER, SR;WILDER, RL
客观的。检查纤维肌痛 (FM) 患者的基础和刺激下丘脑 - 垂体 - 肾上腺 (HPA) 轴和相关激素水平，包括促肾上腺皮质激素 (ACTH)、皮质醇、精氨酸加压素 (AVP) 和神经肽 Y (NPY)。方法。在 12 名 FM 患者以及年龄和性别匹配的正常受试者中评估了基础和绵羊促肾上腺皮质激素释放激素 (oCRH) 刺激的 HPA 轴功能。评估基础血浆 AVP 水平和姿势改变后 AVP 释放，并测量同一样本中的血浆 NPY 水平。结果。与正常受试者相比，FM 患者的 24 小时尿游离皮质醇水平较低，但血浆皮质醇峰值和谷值水平正常。 FM 中对 oCRH 的净综合 ACTH 反应与正常受试者没有显着差异，但倾向于夸大反应。 FM 患者对 oCRH 的净综合皮质醇反应显着下降，表明肾上腺反应低下。 FM 患者和对照受试者之间的 AVP 水平没有显着差异，但 FM 患者之间的变异性更大。 FM患者血浆NPY水平显着低于正常人。结论。这些数据支持 FM 患者的 HPA 轴功能受到干扰的观点。需要进一步研究来确定 HPA 轴扰动的原因及其与 FM 患者症状的关系。
Objective. To examine basal and stimulated hypothalamic-pituitary-adrenal (HPA) axis and related hormone levels, including adrenocorticotropin (ACTH), cortisol, arginine vasopressin (AVP), and neuropeptide Y (NPY), in patients with fibromyalgia (FM).Methods. Basal and ovine corticotropin-releasing hormone (oCRH)-stimulated HPA axis function were assessed in 12 patients with FM and in age- and sex-matched normal subjects. Basal plasma AVP levels and AVP release after postural change were assessed, and plasma NPY levels were measured in the same samples.Results. Patients with FM had low 24-hour urinary free cortisol, but normal peak and elevated trough plasma cortisol levels, compared with normal subjects. The net integrated ACTH response to oCRH in FM was not significantly different from that in normal subjects, but tended toward an exaggerated response. There was a significant decrease in net integrated cortisol response to oCRH in FM patients, indicating adrenal hyporesponsiveness. AVP levels were not significantly different between FM patients and control subjects, but variability was greater among the FM patients. Plasma NPY levels were significantly lower in FM patients than in normal subjects.Conclusion. These data support the view that HPA axis function is perturbed in patients with FM. Further study is required to ascertain the cause of HPA axis perturbations and their relationship to symptoms in patients with FM.