Šimůnková K, Stárka L, Hill M, Kříž L, Hampl R, Vondra K
Institute of Endocrinology, Prague, Czech Republic.
Physiol Res. 2008;57 Suppl 1:S193-9. doi: 10.33549/physiolres.931505. Epub 2008 Feb 13.
The objective of this study was to evaluate the influence of low-dose combined oral contraception (COC) on basal and stimulated (1 microg ACTH test) levels of serum and salivary cortisol (F), cortisone and on basal serum cortisol binding globulin (CBG), adrenocorticotropic hormone (ACTH), dehydroepiadrosterone (DHEA) and calculated free cortisol in healthy young women. Three-month administration of COC resulted in 1) significant increase of basal (454.0+/-125.0 to 860.9+/-179.7 nmol/l) and ACTH-stimulated serum cortisol in 30th min (652.3+/-60.5 to 1374.1+/-240.6 nmol/l); 2) no significant change of basal (15.4+/-7.3 to 18.9+/-8.5 nmol/l) and ACTH-stimulated salivary cortisol at the 30th min (32.4+/-8.8 to 32.9+/-9.0 nmol/l); 3) no significant change of basal serum cortisone (38,8+/-7.68 to 45.2+/-24.2 nmol/l) and ACTH-stimulated cortisone at the 30th (34.8+/-10.9 to 47.0+/-35.7 nmol/l); 4) significant increase of basal ACTH (17.2+/-9.0 to 38.2+/-29.4 ng/l), CBG (991.0+/-161.0 to 2332.0+/-428.0 nmol/l), and 5) no significant change of basal DHEA (24.6+/-15.7 to 22.6+/-11.7 micromol/l) and calculated basal value for free cortisol (22.8+/-14.9 to 19.2+/-6.9 nmol/l). In conclusions, higher basal and ACTH-stimulated serum cortisol were found after three-month administration of COC, while basal and stimulated salivary cortisol were not significantly affected. Therefore, salivary cortisol can be used for assessment of adrenal function in women regularly using COC.
本研究的目的是评估低剂量复方口服避孕药（COC）对健康年轻女性血清和唾液皮质醇（F）、可的松的基础水平及刺激水平（1微克促肾上腺皮质激素试验），以及基础血清皮质醇结合球蛋白（CBG）、促肾上腺皮质激素（ACTH）、脱氢表雄酮（DHEA）和计算得出的游离皮质醇的影响。三个月的COC给药导致：1）基础血清皮质醇（从454.0±125.0纳摩尔/升增至860.9±179.7纳摩尔/升）及ACTH刺激后第30分钟血清皮质醇显著升高（从652.3±60.5纳摩尔/升增至1374.1±240.6纳摩尔/升）；2）基础唾液皮质醇（从15.4±7.3纳摩尔/升增至18.9±8.5纳摩尔/升）及ACTH刺激后第30分钟唾液皮质醇无显著变化（从32.4±8.8纳摩尔/升增至32.9±9.0纳摩尔/升）；3）基础血清可的松（从38.8±7.68纳摩尔/升增至45.2±24.2纳摩尔/升）及ACTH刺激后第30分钟可的松无显著变化（从34.8±10.9纳摩尔/升增至47.0±35.7纳摩尔/升）；4）基础ACTH显著升高（从17.2±9.0纳克/升增至38.2±29.4纳克/升），CBG显著升高（从991.0±161.0纳摩尔/升增至2332.0±428.0纳摩尔/升）；5）基础DHEA无显著变化（从24.6±15.7微摩尔/升降至22.6±11.7微摩尔/升），计算得出的基础游离皮质醇值无显著变化（从22.8±14.9纳摩尔/升降至19.2±6.9纳摩尔/升）。总之，COC给药三个月后，基础及ACTH刺激后的血清皮质醇升高，而基础及刺激后的唾液皮质醇未受显著影响。因此，唾液皮质醇可用于定期服用COC的女性肾上腺功能的评估。
