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亨廷顿舞蹈病中的神经内分泌紊乱

Neuroendocrine disturbances in Huntington's disease.

作者信息

Saleh Nadine, Moutereau Stéphane, Durr Alexandra, Krystkowiak Pierre, Azulay Jean-Philippe, Tranchant Christine, Broussolle Emmanuel, Morin Françoise, Bachoud-Lévi Anne-Catherine, Maison Patrick

机构信息

Centre de référence maladie de Huntington, AP-HP, Groupe Henri-Mondor Albert-Chenevier/Pitié Salpétrière, Créteil, Paris, France.

出版信息

PLoS One. 2009;4(3):e4962. doi: 10.1371/journal.pone.0004962. Epub 2009 Mar 25.

Abstract

BACKGROUND

Huntington's disease (HD) is a severe inherited neurodegenerative disorder characterized, in addition to neurological impairment, by weight loss suggesting endocrine disturbances. The aims of this study were to look for neuroendocrine disturbances in patients with Huntington's disease (HD) and to determine the relationship with weight loss seen in HD METHODS AND FINDING: We compared plasma levels of hormones from the five pituitary axes in 219 patients with genetically documented HD and in 71 sex- and age-matched controls. Relationships between hormone levels and disease severity, including weight-loss severity, were evaluated. Growth hormone (GH) and standard deviation score of insulin-like growth factor 1 (SDS IGF-1) were significantly higher in patients than in controls (0.25 (0.01-5.89) vs. 0.15 (0.005-4.89) ng/ml, p = 0.013 and 0.16+/-1.02 vs. 0.06+/-0.91, p = 0.039; respectively). Cortisol was higher (p = 0.002) in patients (399.14+/-160.5 nmol/L vs. 279.8+/-130.1 nmol/L), whereas no differences were found for other hormone axes. In patients, elevations in GH and IGF-1 and decreases in thyroid-stimulating hormone, free triiodothyronine and testosterone (in men) were associated with severity of impairments (Independence scale, Functional score, Total Functional Capacity, Total Motor score, Behavioral score). Only GH was independently associated with body mass index (beta = -0.26, p = 0.001).

CONCLUSION

Our data suggest that the thyrotropic and in men gonadotropic axes are altered in HD according to the severity of the disease. The somatotropic axis is overactive even in patients with early disease, and could be related to the weight loss seen in HD patients.

摘要

背景

亨廷顿舞蹈症(HD)是一种严重的遗传性神经退行性疾病,除神经功能损害外,其特征还包括体重减轻,提示存在内分泌紊乱。本研究的目的是寻找亨廷顿舞蹈症(HD)患者的神经内分泌紊乱情况,并确定其与HD患者体重减轻之间的关系。方法与发现:我们比较了219例基因确诊的HD患者和71例性别及年龄匹配的对照组患者五个垂体轴的血浆激素水平。评估了激素水平与疾病严重程度(包括体重减轻严重程度)之间的关系。患者的生长激素(GH)和胰岛素样生长因子1标准差评分(SDS IGF-1)显著高于对照组(分别为0.25(0.01 - 5.89)对0.15(0.005 - 4.89)ng/ml,p = 0.013;以及0.16±1.02对0.06±0.91,p = 0.039)。患者的皮质醇水平更高(p = 0.002)(399.14±160.5 nmol/L对279.8±130.1 nmol/L),而其他激素轴未发现差异。在患者中,GH和IGF-1升高以及促甲状腺激素、游离三碘甲状腺原氨酸和男性睾酮降低与损害严重程度相关(独立量表、功能评分、总功能能力、总运动评分、行为评分)。只有GH与体重指数独立相关(β = -0.26,p = 0.001)。

结论

我们的数据表明,HD患者的促甲状腺轴和男性促性腺轴根据疾病严重程度发生改变。即使是早期疾病患者,生长激素轴也过度活跃,这可能与HD患者的体重减轻有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bee4/2655649/6ae0957be3f3/pone.0004962.g001.jpg

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