Golier Julia A, Schmeidler James, Legge Juliana, Yehuda Rachel
Department of Psychiatry, James J Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA.
Psychoneuroendocrinology. 2006 Nov;31(10):1181-9. doi: 10.1016/j.psyneuen.2006.08.005. Epub 2006 Oct 16.
To examine whether PTSD or post-deployment health symptoms in veterans of the first Gulf War (Operation Desert Shield/Storm) are associated with enhanced suppression of the pituitary-adrenal axis to low-dose dexamethasone (DEX).
Plasma cortisol and lymphocyte glucocorticoid receptor (GR) number were measured at 08:00 h on two consecutive days, before and after administration of 0.5mg of DEX at 23:00 h in 42 male Gulf War veterans (14 without psychiatric illness, 16 with PTSD only, and 12 with both PTSD and MDD) and 12 healthy male veterans not deployed to the Gulf War or another war zone.
In the absence of group differences in basal cortisol levels or GR number, Gulf War veterans without psychiatric illness and Gulf War veterans with PTSD only had significantly greater cortisol suppression to DEX than non-deployed veterans and Gulf War veterans with both PTSD and MDD. Gulf War deployment was associated with significantly greater cortisol suppression to DEX controlling for weight, smoking status, PTSD, and MDD; PTSD was not associated with response to DEX. Among Gulf War veterans musculoskeletal symptoms were significantly associated with cortisol suppression and those who reported taking anti-nerve gas pills (i.e., pyridostigmine bromide) during the war had significantly greater DEX-induced cortisol suppression than those who did not.
The data demonstrate that alterations in neuroendocrine function are associated with deployment to the Gulf War and post-deployment musculoskeletal symptoms, but not PTSD. Additional studies are needed to examine the relationship of enhanced glucocorticoid responsivity to deployment exposures and chronic unexplained medical symptoms in Gulf War veterans.
研究第一次海湾战争（沙漠盾牌/风暴行动）退伍军人的创伤后应激障碍（PTSD）或部署后健康症状是否与垂体-肾上腺轴对低剂量地塞米松（DEX）的抑制增强有关。
在42名男性海湾战争退伍军人（14名无精神疾病、16名仅有PTSD、12名同时患有PTSD和重度抑郁障碍[MDD]）以及12名未被部署到海湾战争或其他战区的健康男性退伍军人中，于连续两天的08:00测量血浆皮质醇和淋巴细胞糖皮质激素受体（GR）数量，在23:00给予0.5mg DEX之前和之后进行测量。
在基础皮质醇水平或GR数量无组间差异的情况下，无精神疾病的海湾战争退伍军人和仅有PTSD的海湾战争退伍军人对DEX的皮质醇抑制作用明显大于未部署的退伍军人以及同时患有PTSD和MDD的海湾战争退伍军人。控制体重、吸烟状况、PTSD和MDD后，海湾战争部署与对DEX的皮质醇抑制作用明显增强有关；PTSD与对DEX的反应无关。在海湾战争退伍军人中，肌肉骨骼症状与皮质醇抑制作用显著相关，且那些报告在战争期间服用抗神经毒气药丸（即溴化吡啶斯的明）的人比未服用者的DEX诱导的皮质醇抑制作用明显更大。
数据表明神经内分泌功能的改变与部署到海湾战争及部署后肌肉骨骼症状有关，但与PTSD无关。需要进一步研究来探讨糖皮质激素反应性增强与海湾战争退伍军人的部署暴露及慢性不明原因医学症状之间的关系。
