ROLE OF GLUCOCORTICOIDS IN REGULATION OF THYROID FUNCTION IN MAN
ROLE OF GLUCOCORTICOIDS IN REGULATION OF THYROID FUNCTION IN MAN
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DOI：
10.1172/jci106411
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发表时间：
1970-01-01
影响因子：
15.9
通讯作者：
APPLEMAN, MD
中科院分区：
文献类型：
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作者：
NICOLOFF, JT;FISHER, DA;APPLEMAN, MD
先前在甲状腺功能正常的受试者中观察到的甲状腺碘释放的昼夜变化似乎与血清免疫测定促甲状腺素（TSH）的变化相关。提出的假设是，这种昼夜节律似乎主要受到循环氢化可的松的负反馈作用的调节。对原发性肾上腺功能不全患者给予维持剂量的氢化可的松，对甲状腺功能正常的受试者给予药物剂量的氢化可的松，伴随着甲状腺碘释放和血清 TSH 值的急性抑制。观察到在 2 或 3 天内发生了糖皮质激素抑制的逃脱，甲状腺碘释放率恢复到接近正常，但伴随着正常昼夜节律的减弱或消失。在甲状腺功能正常的受试者中停药药理剂量的糖皮质激素以及在原发性肾上腺功能减退患者中维持剂量的停药伴随着血清TSH和甲状腺碘释放值的短暂刺激。对患者进行冷冻垂体切除术前后的研究表明，类固醇停药后甲状腺释放的反弹反应可能是间接评估下丘脑垂体 TSH 储备能力的有用测试程序。
The diurnal variation in thyroidal iodine release previously observed in euthyroid subjects appears to correlate with variations in serum immunoassayable thyrotropin (TSH). The hypothesis is advanced that this diurnal rhythm seems to be primarily regulated by a negative feedback action of circulating hydrocortisone. The administration of maintenance doses of hydrocortisone to patients with primary adrenal insufficiency and pharmacological doses to euthyroid subjects was accompanied by an acute suppression in both thyroidal iodine release and serum TSH values. An escape from glucocorticoid suppression was observed to occur in 2 or 3 days with the resumption of a near-normal thyroidal iodine release rate but was accompanied by a dampening or absence of the normal diurnal rhythm. Withdrawal of pharmacological doses of glucocorticoids in euthyroid subjects and maintenance doses in primary hypoadrenal patients was accompanied by transient stimulation of both serum TSH and thyroidal iodine release values. The study of a patient before and after cryohypophysectomy indicated that the rebound response in thyroid release after steroid withdrawal may be a useful testing procedure to indirectly assess the hypothalamicpituitary reserve capacity of TSH.Images