Intact circadian rhythm despite cortisol hypersecretion in Alzheimer's disease: A meta-analysis.
Intact circadian rhythm despite cortisol hypersecretion in Alzheimer's disease: A meta-analysis.
复制标题
尽管阿尔茨海默氏病皮质醇分泌过多，但昼夜节律完整：一项荟萃分析。
DOI：
10.1016/j.psyneuen.2021.105367
复制
发表时间：
2021
影响因子：
3.7
通讯作者：
Moffat,ScottD
中科院分区：
文献类型：
--
作者：
Saelzler,UrsulaG;Verhaeghen,Paul;Panizzon,MatthewS;Moffat,ScottD
几十年来，人们一直怀疑阿尔茨海默病（AD）患者的糖皮质激素类固醇激素皮质醇分泌过多，在此期间，对这一现象进行了数十次检查并发表。本研究的目的是总结这一庞大的文献，测试参与者和方法学特征是否改变AD相关的基底皮质醇高分泌的程度，并检查AD患者是否维持皮质醇的昼夜节律。为此，本荟萃分析和系统综述检查了300多个AD患者和认知正常老年人之间基础hpa轴功能指标的比较。AD与基础皮质醇升高相关（g= 0.45），但影响的大小不受考虑的任何参与者特征或皮质醇采样的时间的系统影响。此外，没有证据表明昼夜节律性的直接指标（如皮质醇觉醒反应或皮质醇日斜率）存在组间差异。这些结果表明，皮质醇的基础高分泌，而不是昼夜节律障碍，是AD患者的特征。从机制上讲，观察到的高分泌与ad驱动的海马退化和随后的下丘脑-垂体-肾上腺轴抑制减少的理论一致。需要进一步的研究来阐明皮质醇升高在阿尔茨海默病进展中的作用和时间。
Hypersecretion of the glucocorticoid steroid hormone cortisol by individuals with Alzheimer’s disease (AD) has been suspected for several decades, during which time dozens of examinations of this phenomenon have been conducted and published. The goals of this investigation were to summarize this sizeable body of literature, test whether participant and methodological characteristics modify the magnitude of the AD-associated basal cortisol hypersecretion,and examine whether cortisol circadian rhythmicity is maintained among individuals with AD. To this end, the present meta-analysis and systematic review examined over 300 comparisons of indices of basal HPA-axis functioning between individuals with AD and cognitively normal older adults. AD was associated with basal cortisol elevations (g= 0.45) but the magnitude of the effect was not systematically impacted by any of the participant characteristics considered or the time-of-day of the cortisol sampling. Further, there was no evidence of group differences among direct indices of circadian rhythmicity such as the cortisol awakening response or the diurnal cortisol slope. These results suggest that basal hypersecretion of cortisol, but not circadian dysrhythmia, is characteristic of individuals with AD. Mechanistically, the observed hypersecretion is consistent with the theorized AD-driven deterioration of the hippocampus and subsequent reduction in hypothalamic-pituitary-adrenal axis inhibition. Further investigation is warranted to elucidate the role and timing of cortisol elevations in the progression of AD.