Endocrine Service, Medical Section, Salem Veterans Affairs Medical Center, Salem, VA 24153, USA.
Metabolism. 2011 Nov;60(11):1521-9. doi: 10.1016/j.metabol.2011.03.018. Epub 2011 May 31.
Exercise stimulates coordinated release of the sympathoadrenal hormones adrenocorticotropic hormone (ACTH), cortisol, norepinephrine (NE), and epinephrine (Epi). The study hypothesis was that chronic obstructive pulmonary disease (COPD) is marked by heightened sympathoadrenal outflow at comparable relative workloads. The location of the study was at a clinical research unit. Eight healthy men and 9 men with stable COPD (forced expiratory volume at 1 second <75% predicted) were studied. Volunteers rested (baseline) or exercised at individual submaximal (35% ± 5%) or maximal oxygen consumption. Blood was sampled every 2 minutes for 40 minutes concurrently. Two-way analysis of covariance was applied to examine group (healthy/COPD) and exercise (3 levels) effects on ACTH, cortisol, NE, and Epi release and regularity (estimable by approximate entropy). The timing of peak hormone concentrations was Epi, 14 minutes; NE, 16 minutes; ACTH, 22 minutes; and cortisol, 34 minutes in both cohorts. Type of exercise regimen influenced all 4 hormones (each P < .001), and subject group (control vs COPD) affected cortisol (P < .001) and Epi (P = .048) responses. Exercise regimen and group together controlled ACTH, cortisol, and Epi (each P < .001), but not NE, responses. In particular, endocrine responses were attenuated in COPD compared with control subjects. Approximate entropy analysis also identified loss of maximal exercise-induced ACTH-secretory regularity in COPD patients (P = .042). These outcomes demonstrate impaired rather than augmented exercise-associated sympathocorticotropic-axis outflow in patients with COPD even when outcomes are normalized to maximal oxygen consumption, suggesting that factors other than fitness are at work.
运动刺激交感肾上腺激素促肾上腺皮质激素（ACTH）、皮质醇、去甲肾上腺素（NE）和肾上腺素（Epi）的协调释放。研究假设慢性阻塞性肺疾病（COPD）以相当的相对工作量为标志，表现为交感肾上腺流出增加。研究地点位于临床研究单位。研究了 8 名健康男性和 9 名稳定的 COPD 男性（第 1 秒用力呼气量<75%预计值）。志愿者休息（基线）或在个体亚最大（35%±5%）或最大耗氧量下运动。同时在 40 分钟内每 2 分钟采集一次血液样本。应用双向方差分析来检验组（健康/COPD）和运动（3 个水平）对 ACTH、皮质醇、NE 和 Epi 释放和规律性（近似熵估计）的影响。激素浓度峰值的时间为 Epi，14 分钟；NE，16 分钟；ACTH，22 分钟；皮质醇，两组均为 34 分钟。运动方案类型影响所有 4 种激素（每种 P<0.001），并且受试组（对照组与 COPD 组）影响皮质醇（P<0.001）和 Epi（P=0.048）反应。运动方案和组一起控制 ACTH、皮质醇和 Epi（每种 P<0.001），但不控制 NE 反应。特别是，与对照组相比，COPD 患者的内分泌反应减弱。近似熵分析还确定了 COPD 患者在最大运动诱导的 ACTH 分泌规律性丧失（P=0.042）。这些结果表明，即使将结果归一化为最大耗氧量，COPD 患者的运动相关交感肾上腺轴流出也受损而不是增强，这表明起作用的不仅仅是健康因素。
