Veldhuis Johannes D, Roelfsema Ferdinand, Iranmanesh Ali, Carroll Bernard J, Keenan Daniel M, Pincus Steven M
Endocrine Research Unit, Mayo Medical School, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota 55905, USA.
J Clin Endocrinol Metab. 2009 Oct;94(10):4045-52. doi: 10.1210/jc.2009-1143. Epub 2009 Sep 15.
Age, gender, and BMI determine ultradian modes of LH and GH secretion, viz., pulsatile, basal, pattern-defined regularity [approximate entropy (ApEn)] and spikiness (sharp, brief excursions). Whether the same determinants apply to ACTH secretion is not known.
The study was conducted at a tertiary medical center.
We studied normal women (n = 22) and men (n = 26) [ages, 23-77 yr; body mass index (BMI), 21-32 kg/m(2)].
Volunteers underwent 10-min blood sampling to create 24-h ACTH concentration profiles.
Dynamic measures of ACTH secretion were studied.
Mean ACTH concentrations (R(2) = 0.15; P = 0.006) and both pulsatile (R(2) = 0.12; P = 0.018) and basal (nonpulsatile) (R(2) = 0.16; P = 0.005) ACTH secretion correlated directly with BMI (n = 48). Men had greater basal (P = 0.047), pulsatile (P = 0.031), and total (P = 0.010) 24-h ACTH secretion than women, including when total secretion was normalized for BMI (P = 0.019). In men, both ACTH-cortisol feedforward and cortisol-ACTH feedback asynchrony (cross-ApEn) increased with age (R(2) = 0.20 and 0.22; P = 0.021 and 0.018). ACTH spikiness rose with age (P = 0.046), principally in women. Irregularity of cortisol secretion (ApEn) increased with age (n = 48; P = 0.010), especially in men. In both sexes, percentage pulsatile ACTH secretion predicted 24-h mean cortisol concentrations (R(2) = 0.14; P = 0.009).
Valid comparisons of ultradian ACTH dynamics will require cohorts matched for age, gender, and BMI, conditions hitherto not satisfied in most physiological studies of this axis.
年龄、性别和体重指数决定促黄体生成素（LH）和生长激素（GH）分泌的超日节律模式，即脉冲式、基础式、模式定义的规律性[近似熵（ApEn）]和峰值性（尖锐、短暂波动）。目前尚不清楚这些因素是否适用于促肾上腺皮质激素（ACTH）分泌。
该研究在一家三级医疗中心进行。
我们研究了正常女性（n = 22）和男性（n = 26）[年龄23 - 77岁；体重指数（BMI）21 - 32 kg/m²]。
志愿者接受10分钟的采血，以建立24小时促肾上腺皮质激素浓度曲线。
对促肾上腺皮质激素分泌的动态指标进行了研究。
平均促肾上腺皮质激素浓度（R² = 0.15；P = 0.006）以及脉冲式（R² = 0.12；P = 0.018）和基础式（非脉冲式）（R² = 0.16；P = 0.005）促肾上腺皮质激素分泌均与体重指数直接相关（n = 48）。男性24小时基础促肾上腺皮质激素分泌（P = 0.047）、脉冲式分泌（P = 0.031）和总分泌量（P = 0.010）均高于女性，包括按体重指数标准化后的总分泌量（P = 0.019）。在男性中，促肾上腺皮质激素 - 皮质醇前馈和皮质醇 - 促肾上腺皮质激素反馈异步性（交叉近似熵）均随年龄增加（R² = 0.20和0.22；P = 0.021和0.018）。促肾上腺皮质激素峰值性随年龄增加（P = 0.046），主要见于女性。皮质醇分泌的不规律性（近似熵）随年龄增加（n = 48；P = 0.010），尤其在男性中。在两性中，脉冲式促肾上腺皮质激素分泌百分比可预测24小时平均皮质醇浓度（R² = 0.14；P = 0.009）。
对促肾上腺皮质激素超日节律动力学进行有效比较需要年龄、性别和体重指数匹配的队列，而在该轴的大多数生理学研究中，这一条件迄今尚未得到满足。
