Maes M, Minner B, Suy E, D'Hondt P, Jacobs M P, Raus J
Psychiatric Centre, Munsterbilzen, Belgium.
Psychoneuroendocrinology. 1991;16(4):295-310. doi: 10.1016/0306-4530(91)90016-m.
We determined baseline 0800h plasma cortisol concentrations, 24-hr urinary free cortisol (UFC) excretion, the post-dexamethasone cortisol values at 0800h and 1600h, and the 0800h dexamethasone concentrations in 60 depressed patients categorized according to the DSM-III. Up to 59% of the variability in the 0800h post-dexamethasone cortisol values could be explained by the multiple regression on UFC, 0800h basal plasma cortisol, age (all positively related), and dexamethasone concentrations (negatively related). The 1600h post-dexamethasone cortisol data were best explained (i.e., 55% of the variance) by the multiple regression on basal plasma cortisol, UFC (positive) and dexamethasone (negative). After controlling for UFC, baseline plasma cortisol, and age no significant effects of the depressive state (diagnostic classification or severity of illness) on the post-dexamethasone cortisol values could be detected. It can be deduced that cortisol non-suppression during depression is related strongly to baseline cortisol hypersecretion and increasing age. These factors are additive and contribute independently towards cortisol escape from suppression by dexamethasone.
我们测定了60名根据《精神疾病诊断与统计手册》第三版（DSM-III）分类的抑郁症患者的基线08:00血浆皮质醇浓度、24小时尿游离皮质醇（UFC）排泄量、地塞米松给药后08:00和16:00的皮质醇值以及08:00的地塞米松浓度。地塞米松给药后08:00皮质醇值高达59%的变异性可通过对UFC、08:00基础血浆皮质醇、年龄（均呈正相关）和地塞米松浓度（呈负相关）进行多元回归来解释。地塞米松给药后16:00皮质醇数据通过对基础血浆皮质醇、UFC（正相关）和地塞米松（负相关）进行多元回归得到了最佳解释（即55%的方差）。在控制了UFC、基线血浆皮质醇和年龄后，未检测到抑郁状态（诊断分类或疾病严重程度）对地塞米松给药后皮质醇值有显著影响。可以推断，抑郁症期间皮质醇不被抑制与基线皮质醇分泌过多和年龄增长密切相关。这些因素具有累加性，且各自独立地导致皮质醇无法被地塞米松抑制。
