Sakaue K
Department of Neuropsychiatry, Tokyo Medical and Dental University, Japan.
Nihon Naibunpi Gakkai Zasshi. 1990 Oct 20;66(10):1094-107. doi: 10.1507/endocrine1927.66.10_1094.
With a highly sensitive time-resolved fluorometric immunoassay (TR-FIA), serum thyrotropin (TSH) levels were determined in various conditions in healthy subjects. In addition, we compared the thyroid function in 10 depressed female patients with that in 27 female controls. 1) We evaluated a highly sensitive time-resolved fluorometric immunoassay kit for serum TSH. The lower limit of detection of TSH in serum was 0.008 less than U/ml. The intraassay and interassay variances were 3.0 greater than 3.6% and 3.4 greater than 5.1%, respectively. There was a significant correlation between basal TSH levels and maximum TSH values after TRH administration (r = 0.797, p less than 0.01). 2) The mean TSH levels in 31 healthy controls of both sexes was 1.26 +/- 0.96 less than U/ml, but TSH levels in women were significantly higher than in men (p less than 0.01). A large intra-individual variation of serum TSH levels determined on different days was found equally in both men and women. The nyctohemeral elevation of TSH levels was not clearly seen prior to the onset of normal sleep, but the nocturnal rise of TSH levels was remarkably accentuated by sleep deprivation. 3) The serum TSH levels in depressed female patients were significantly lower than those in healthy female controls when the post-menopausal subjects were excluded. For the serum thyroid hormone concentrations, serum T4 levels were normal. Serum free T3 levels tended to be lower, although the reduction was not significant. The serum levels of these 3 thyroid hormones were not related to serum TSH values. The present study demonstrated a large variation of TSH levels in various conditions, even in the same individuals, indicating the necessity of strictly controlled conditions in the study of TSH secretion. A significant reduction in TSH levels was observed in the depressed female patients when the post-menopausal subjects were excluded. Our results suggest that the dysfunction of the regulating mechanism of the pituitary-thyroid axis in depression may occur at a pituitary or a suprapituitary level.
采用高灵敏度时间分辨荧光免疫分析法（TR-FIA），测定了健康受试者在不同情况下的血清促甲状腺激素（TSH）水平。此外，我们比较了10例抑郁女性患者与27例女性对照者的甲状腺功能。1）我们评估了一种用于血清TSH的高灵敏度时间分辨荧光免疫分析试剂盒。血清中TSH的检测下限小于0.008 μU/ml。批内和批间变异分别大于3.0%和3.6%，以及大于3.4%和5.1%。TRH给药后基础TSH水平与最大TSH值之间存在显著相关性（r = 0.797，p小于0.01）。2）31例健康男女对照者的平均TSH水平为1.26±0.96 μU/ml，但女性的TSH水平显著高于男性（p小于0.01）。在男性和女性中均发现不同日期测定的血清TSH水平存在较大的个体内差异。在正常睡眠开始前，TSH水平的昼夜升高并不明显，但睡眠剥夺会显著加剧TSH水平的夜间升高。3）排除绝经后受试者后，抑郁女性患者的血清TSH水平显著低于健康女性对照者。对于血清甲状腺激素浓度，血清T4水平正常。血清游离T3水平有降低趋势，尽管降低不显著。这三种甲状腺激素的血清水平与血清TSH值无关。本研究表明，即使在同一受试者中，TSH水平在不同情况下也存在很大差异，这表明在TSH分泌研究中需要严格控制条件。排除绝经后受试者后，抑郁女性患者的TSH水平显著降低。我们的结果表明，抑郁症患者垂体-甲状腺轴调节机制的功能障碍可能发生在垂体或垂体以上水平。
