Uhart Magdalena, Chong Rachel Y, Oswald Lynn, Lin Ping-I, Wand Gary S
Department of Medicine, The Johns Hopkins University School of Medicine, 720 Rutland Avenue, Room 863, Baltimore, MD 21205, USA.
Psychoneuroendocrinology. 2006 Jun;31(5):642-52. doi: 10.1016/j.psyneuen.2006.02.003. Epub 2006 Apr 17.
The present study was designed to determine whether there are gender differences in hormonal response patterns to HPA axis activation. To this end, two methods of activating the HPA axis were employed: a standardized psychological stress test and a pharmacological challenge. Healthy subjects (mean age 23.4 years, SD 7.0 years) completed a naloxone challenge and/or the modified Trier Social Stress Test (TSST). For the naloxone challenge, two baseline blood samples were obtained. Placebo was then administered (0 min), followed by increasing doses of intravenous naloxone (50, 100, 200 and 400 microg/kg) at 30-min intervals. Post-placebo blood samples were collected at 15-min intervals for 180 min. The TSST consisted of 5 min of public speaking followed by 5 min of mental arithmetic exercises. Three baseline and five post-TSST blood samples were drawn. Eighty subjects (53 male, 27 female) underwent the TSST. Following the psychological stressor, adrenocorticotropin (ACTH) and cortisol responses were significantly greater in male subjects compared to female subjects (z=-2.34, p=0.019 and z=-2.12, p=0.034, respectively). Seventy-two subjects (52 male, 20 female) underwent HPA axis activation induced by naloxone. In contrast to the TSST, cortisol responses to the naloxone challenge were significantly greater in female subjects compared to male subjects (z=4.11, p<0.001). Forty-one subjects (25 male, 16 female) completed both the TSST and naloxone challenge. In this subset, ACTH and cortisol responses to the TSST did not differ significantly by gender, although the effect size was moderate to large. Adrenocorticotropin and cortisol responses to the naloxone challenge were significantly greater in female subjects compared to male subjects (z=2.29, p=0.022 and z=4.34, p<0.001, respectively). In summary, male subjects had greater HPA axis responses to a psychological stressor than female subjects, and females had greater hormonal reactivity than males to pharmacological stimulation with naloxone. Such differences are of interest as potential contributors to gender differences in health risks.
本研究旨在确定在对HPA轴激活的激素反应模式上是否存在性别差异。为此，采用了两种激活HPA轴的方法：标准化心理应激测试和药物激发试验。健康受试者（平均年龄23.4岁，标准差7.0岁）完成了纳洛酮激发试验和/或改良的特里尔社会应激测试（TSST）。对于纳洛酮激发试验，采集了两份基线血样。然后给予安慰剂（0分钟），随后每隔30分钟静脉注射递增剂量的纳洛酮（50、100、200和400微克/千克）。在180分钟内每隔15分钟采集一次安慰剂后血样。TSST包括5分钟的公开演讲，随后是5分钟的心算练习。采集了三份基线血样和五份TSST后血样。80名受试者（53名男性，27名女性）接受了TSST。在心理应激源作用后，男性受试者的促肾上腺皮质激素（ACTH）和皮质醇反应显著大于女性受试者（z=-2.34，p=0.019；z=-2.12，p=0.034）。72名受试者（52名男性，20名女性）接受了纳洛酮诱导的HPA轴激活。与TSST相反，女性受试者对纳洛酮激发试验的皮质醇反应显著大于男性受试者（z=4.11，p<0.001）。41名受试者（25名男性，16名女性）完成了TSST和纳洛酮激发试验。在这个亚组中，尽管效应大小为中度到高度，但ACTH和皮质醇对TSST的反应在性别上没有显著差异。女性受试者对纳洛酮激发试验的促肾上腺皮质激素和皮质醇反应显著大于男性受试者（分别为z=2.29，p=0.022；z=4.34,p<0.001）。总之，男性受试者对心理应激源的HPA轴反应大于女性受试者，而女性对纳洛酮药物刺激的激素反应性大于男性。这些差异作为健康风险中性别差异的潜在因素具有重要意义。
