Birmaher B, Dahl R E, Williamson D E, Perel J M, Brent D A, Axelson D A, Kaufman J, Dorn L D, Stull S, Rao U, Ryan N D
Western Psychiatric Institute and Clinic, 3811 O'Hara St, Pittsburgh, PA 15213, USA.
Arch Gen Psychiatry. 2000 Sep;57(9):867-72. doi: 10.1001/archpsyc.57.9.867.
Decreased growth hormone (GH) response to pharmacologic stimulation has been found in children and adolescents during an episode of major depressive disorder and after recovery. In this study, we sought to determine whether GH secretion is similarly altered in children and adolescents who had never experienced depression but were at high risk of developing depression.
Subjects were 8 through 16 years of age and selected for high- and low-risk status according to familial loading for mood disorders. Sixty-four high-risk and 55 low-risk healthy subjects participated in the study, which assessed the following GH measures: (1) GH before growth hormone-releasing hormone (GHRH) infusion, every 15 minutes for 30 minutes; (2) GH response after intravenous infusion of GHRH (0.1 microg/kg), every 15 minutes for 90 minutes; and (3) nocturnal GH every 20 minutes from 9 PM until morning awakening.
After stimulation with GHRH, the high-risk subjects secreted significantly less GH compared with the low-risk healthy controls (effect sizes for mean and peak GH, 0.52 [P =.007] and 0.40 [P =.04], respectively). In contrast, there were no between-group differences in the pre-GHRH and nocturnal GH secretion levels. Exposure to recent stressors was not associated with GH secretion.
Taken together with previous evidence of decreased GH after GHRH infusion in acutely depressed and recovered children, these results indicate that the decreased GH response found in high-risk subjects may represent a trait marker for depression in children and adolescents.
在儿童和青少年患重度抑郁症期间及康复后,已发现其对药物刺激的生长激素(GH)反应降低。在本研究中,我们试图确定在从未经历过抑郁症但有患抑郁症高风险的儿童和青少年中,GH分泌是否有类似改变。
研究对象为8至16岁的儿童,根据情绪障碍的家族负荷分为高风险和低风险状态。64名高风险和55名低风险健康受试者参与了本研究,该研究评估了以下GH指标:(1)在注射生长激素释放激素(GHRH)前的GH水平,每15分钟测量一次,共30分钟;(2)静脉注射GHRH(0.1微克/千克)后的GH反应,每15分钟测量一次,共90分钟;(3)从晚上9点到早晨醒来,每20分钟测量一次夜间GH水平。
与低风险健康对照组相比,高风险受试者在接受GHRH刺激后分泌的GH显著减少(平均GH和峰值GH的效应量分别为0.52 [P = 0.007]和0.40 [P = 0.04])。相比之下,GHRH注射前和夜间GH分泌水平在两组之间没有差异。近期接触应激源与GH分泌无关。
结合先前关于急性抑郁和康复儿童在注射GHRH后GH降低的证据,这些结果表明,在高风险受试者中发现的GH反应降低可能是儿童和青少年抑郁症的一个特质标记。