Demir H, Keleştimur F, Tunç M, Kirnap M, Ozügül Y
Department of Physical Medicine and Rehabilitation, Erciyes University, Medical School, Kayseri, Turkey.
Scand J Rheumatol. 1999;28(1):41-6. doi: 10.1080/03009749950155779.
Rheumatoid arthritis (RA) is a systemic disease and is associated with cytokines (IL-1, IL-6, TNF-alpha) production. There is little information on hypothalamo-pituitary-adrenal (HPA) axis and growth hormone (GH) axis in the patients with RA. We have, therefore, investigated these systems in twenty patients with confirmed RA. Ten of the patients had active and 10 patients remitted RA. Serum cortisol, ACTH and GH levels were measured in the basal state and after insulin induced hypoglycaemia. Cortisol, adrenocorticotropic hormone (ACTH) and GH responses were impaired in 65%, 85% and 30% of the patients, respectively. The basal and peak hormone levels were similar between the patients with active RA and the patients in remission. These findings indicate that there is an impairment in HPA and GH axis in patients with active and remitted RA. The site of this impairment is probably hypothalamus and/or pituitary gland.
类风湿性关节炎（RA）是一种全身性疾病，与细胞因子（白细胞介素-1、白细胞介素-6、肿瘤坏死因子-α）的产生有关。关于RA患者下丘脑-垂体-肾上腺（HPA）轴和生长激素（GH）轴的信息很少。因此，我们对20例确诊为RA的患者的这些系统进行了研究。其中10例患者患有活动期RA，10例患者处于缓解期RA。在基础状态和胰岛素诱导低血糖后测量血清皮质醇、促肾上腺皮质激素（ACTH）和GH水平。皮质醇、促肾上腺皮质激素（ACTH）和GH反应分别在65%、85%和30%的患者中受损。活动期RA患者和缓解期患者的基础激素水平和峰值激素水平相似。这些发现表明，活动期和缓解期RA患者的HPA轴和GH轴存在损害。这种损害的部位可能是下丘脑和/或垂体。
