Rhythms of pituitary-adrenal activity during sleep in patients with Cushing's disease
Rhythms of pituitary-adrenal activity during sleep in patients with Cushing's disease
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DOI：
10.1055/s-2000-8143
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发表时间：
2000-01-01
影响因子：
1.8
通讯作者：
Fehm, HL
中科院分区：
文献类型：
--
作者：
Bierwolf, C;Kern, W;Fehm, HL
先前的研究表明，健康人夜间垂体-肾上腺分泌活动对中枢神经睡眠过程的依赖性：在正常生理条件下，ACTH/皮质醇的释放在睡眠早期受到抑制，并在睡眠后期进入非快速眼动睡眠。在这里，我们比较了7名库欣病患者与7名年龄和性别匹配的健康对照者夜间血浆ACTH/皮质醇浓度的动态变化。部分患者接受了反复测试。共13晚，其中高脉冲分泌型7晚（5例），低脉冲分泌型6晚（4例）。在适应后，获得夜间多导睡眠仪睡眠记录，并在23.00至7.00之间每15分钟采样一次血液。对照组显示ACTH/皮质醇浓度在夜间早期最低，在夜间后期最高，而库欣患者的ACTH/皮质醇水平表明整个夜间垂体-肾上腺活动相对稳定升高，没有任何昼夜变化。自相关功能显示，健康对照组（155.6+/-17.4 min）和高搏动模式患者（142.4+/-6.6 min）的皮质醇分泌节律具有相似的周期长度。在表现出低脉搏性的患者中，没有观察到明显的节律性。然而，不管分泌性搏动的类型如何，肾上腺分泌活动主要是在非快速眼动睡眠期间开始的
Previous studies have indicated a dependence of nocturnal pituitary-adrenal secretory activity on central nervous sleep processes in healthy humans: Under normal physiological conditions the release of ACTH/cortisol is inhibited during early sleep and becomes entrained to periods of NonREM sleep during late sleep. Here, we compared nocturnal dynamics in plasma concentrations of ACTH/cortisol in 7 patients with Cushing's disease with those of 7 healthy controls matched in age and sex with the patients. The patients in part were repeatedly tested. The total of 13 nights is composed of 7 nights of hyperpulsatile secretion pattern (5 patients) and 6 nights from hypopulsatile secretion pattern (4 patients). After an adaptation night polysomnographic sleep recordings were obtained and blood was sampled every 15 min between 23.00 and 7.00 h. Controls displayed the typical minimum in ACTH/cortisol concentrations during the early part of the night and maximum concentrations during the late part of the night, whereas ACTH/cortisol levels of Cushing patients indicated a relatively constant elevated pituitary-adrenal activity throughout the night, lacking any circadian variation. Autocorrelation functions revealed the presence of cortisol secretory rhythms with a similar period length in healthy controls (155.6+/-17.4 min) and patients with a hyperpulsatile pattern (142.4+/-6.6 min). In patients displaying hypopulsatility, no significant rhythmicity was observed. However, regardless of the type of secretory pulsatility, adrenal secretory activity started predominantly during periods of NonREM sleep (p