Landis C A, Lentz M J, Rothermel J, Riffle S C, Chapman D, Buchwald D, Shaver J L
Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington 98195, USA.
J Clin Endocrinol Metab. 2001 Apr;86(4):1672-8. doi: 10.1210/jcem.86.4.7427.
Fibromyalgia (FM) is a complex syndrome, primarily of women, characterized by chronic pain, fatigue, and sleep disturbance. Altered function of the somatotropic axis has been documented in patients with FM, but little is known about nocturnal levels of PRL. As part of a laboratory study of sleep patterns in FM, we measured the serum concentrations of GH and PRL hourly from 2000--0700 h in a sample of 25 women with FM (mean, 46.9 +/- 7.6 yr) and in 21 control women (mean, 42.6 +/- 8.1 yr). The mean (+/-SEM ) serum concentrations (micrograms per L) of GH and of PRL during the early sleep period were higher in control women than in patients with FM [GH, 1.6 +/- 0.4 vs. 0.6 +/- 0.2 (P < 0.05); PRL, 23.2 +/- 2.2 vs. 16.9 +/- 2.0 (P < 0.025)]. The mean serum concentrations of GH and PRL increased more after sleep onset in control women than in patients with FM [GH, 1.3 +/- 0.4 vs. 0.3 +/- 0.2 (P < 0.05); PRL, 16.2 +/- 2.4 vs. 9.7 +/- 1.5 (P < 0.025)]. Sleep efficiency and amounts of sleep or wake stages on the blood draw night were not different between groups. There was a modest inverse relationship between sleep latency and PRL and a direct relationship between sleep efficiency and PRL in FM. There was an inverse relationship between age and GH most evident in control women. Insulin-like growth factor I levels were not different between the groups. These data demonstrate altered functioning of both the somatotropic and lactotropic axes during sleep in FM and support the hypothesis that dysregulated neuroendocrine systems during sleep may play a role in the pathophysiology of FM.
纤维肌痛（FM）是一种主要发生于女性的复杂综合征，其特征为慢性疼痛、疲劳和睡眠障碍。生长激素轴功能改变在FM患者中已有记录，但关于夜间催乳素（PRL）水平的了解却很少。作为FM睡眠模式实验室研究的一部分，我们在25名FM女性患者（平均年龄46.9±7.6岁）和21名对照女性（平均年龄42.6±8.1岁）中，于20:00至07:00每小时测量一次血清生长激素（GH）和PRL浓度。在睡眠早期，对照女性的GH和PRL平均（±标准误）血清浓度（微克/升）高于FM患者[GH，1.6±0.4 vs. 0.6±0.2（P<0.05）；PRL，23.2±2.2 vs. 16.9±2.0（P<0.025）]。睡眠开始后，对照女性的GH和PRL平均血清浓度升高幅度大于FM患者[GH，1.3±0.4 vs. 0.3±0.2（P<0.05）；PRL，16.2±2.4 vs. 9.7±1.5（P<0.025）]。采血当晚的睡眠效率以及睡眠或清醒阶段的时长在两组之间并无差异。在FM中，睡眠潜伏期与PRL呈适度负相关，睡眠效率与PRL呈正相关。年龄与GH呈负相关，这在对照女性中最为明显。两组之间胰岛素样生长因子I水平无差异。这些数据表明，FM患者睡眠期间生长激素轴和催乳激素轴的功能均发生改变，并支持睡眠期间神经内分泌系统失调可能在FM病理生理学中起作用这一假说。
