Ryan Martina C M, Sharifi Neda, Condren Rita, Thakore Jogin H
Psychobiology Research Group, School of Neurology, Neurobiology and Psychiatry, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
Psychoneuroendocrinology. 2004 Sep;29(8):1065-70. doi: 10.1016/j.psyneuen.2003.08.011.
Evidence for basal hypothalamic-pituitary-adrenal (HPA) axis dysfunction in schizophrenia is less consistent than that seen in major depression. Potential reasons include sampling procedures and the use of patients on antipsychotic medications which may suppress the HPA axis. Therefore, the objective of this study was to determine whether first episode, drug naïve patients with schizophrenia have evidence of basal HPA axis dysfunction by measuring plasma levels of AVP, ACTH and cortisol from 13:00 to 16:00 h, a time frame which is believed to reflect 24 h concentrations of HPA axis activity.
In this cross-sectional study, plasma levels of AVP, ACTH and cortisol were measured in 12 (7 males and 5 females) (mean age +/-SD=33.6+/-12.6 years) patients with DSM-IV schizophrenia and compared with those found in age- and sex-matched healthy controls.
Patients and controls did not differ in terms of their 13:00 h cortisol and AVP. However, patients with schizophrenia had higher levels of ACTH as compared to control subjects at 13:00 h (41.3+/-14.6 vs. 12.4+/-1.1 pg/ml respectively; t=1.99, df=11, p <0.05). In comparison to controls subjects, patients with schizophrenia, had higher mean (+/-SE) AUC of ACTH (26.3+/-6.2 vs. 13.9 nmol/l, respectively; t=2.86, df=11, p <0.02) and cortisol (279.4+/-26.0 vs. 213.1+/-18.4 nmol/l, respectively; t=3.72, df=11, p <0.01). Though, patients with schizophrenia, in comparison to control subjects, had lower mean (+/-SE) AUC of AVP (0.87+/-0.24 vs. 1.42+/-0.34 pmol/l, respectively; t=2.29, df=11, p <0.02).
First episode, drug naïve patients with schizophrenia show evidence of basal overactivity of the pituitary-adrenal axis.
精神分裂症患者下丘脑 - 垂体 - 肾上腺（HPA）轴功能障碍的证据不如重度抑郁症患者那样一致。潜在原因包括采样程序以及使用可能抑制HPA轴的抗精神病药物的患者。因此，本研究的目的是通过测量13:00至16:00时血浆中抗利尿激素（AVP）、促肾上腺皮质激素（ACTH）和皮质醇的水平，来确定首次发作、未使用过药物的精神分裂症患者是否存在基础HPA轴功能障碍的证据，该时间段被认为可反映HPA轴活动的24小时浓度。
在这项横断面研究中，对12名（7名男性和5名女性）（平均年龄±标准差 = 33.6±12.6岁）符合DSM - IV标准的精神分裂症患者测量血浆中AVP、ACTH和皮质醇的水平，并与年龄和性别匹配的健康对照者进行比较。
患者和对照者在13:00时的皮质醇和AVP水平无差异。然而，精神分裂症患者在13:00时的ACTH水平高于对照者（分别为41.3±14.6与12.4±1.1 pg/ml；t = 1.99，自由度 = 11，p <0.05）。与对照者相比，精神分裂症患者的ACTH平均（±标准误）曲线下面积（AUC）更高（分别为26.3±6.2与13.9 nmol/l；t = 2.86，自由度 = 11，p <0.02），皮质醇的AUC也更高（分别为279.4±26.0与213.1±18.4 nmol/l；t = 3.72，自由度 = 11，p <0.01）。不过，与对照者相比，精神分裂症患者的AVP平均（±标准误）AUC更低（分别为0.87±0.24与1.42±0.34 pmol/l；t = 2.29，自由度 = 11，p <0.02）。
首次发作、未使用过药物的精神分裂症患者显示出垂体 - 肾上腺轴基础活动过度的证据。
