Yamamotova Anna, Kmoch Vladimir, Papezova Hana
Department of Normal, Pathological and Clinical Physiology, Charles University, Prague, Czech Republic.
Neuro Endocrinol Lett. 2012;33(4):401-5.
Anorexia nervosa (AN) patients represent a natural model of relationship between changed hormonal level and pain perception due to lower level of sex hormones and consistently described increased pain threshold. As the adrenal stress steroid hormones (cortisol and DHEA) are known to be also changed in AN (and share a common precursor), our study was aimed to analyze the association between these hormones and pain perception in AN patients and control healthy women.
The pain threshold latencies to radiant heat stimuli were measured in 20 DSM-IV diagnosed patients with AN and in 21 healthy women. Blood samples were collected in the morning hours and analyses of the plasma levels of dehydroepiandrosterone (DHEA), its conjugated sulfate ester (DHEA-S) and cortisol were implemented.
Thermal pain threshold was higher in AN than in healthy women and correlated negatively with the level of DHEA and positively with cortisol/DHEA(S) ratio. No significant correlation between thermal pain and hormones was found in healthy women. If both groups were pooled together, the rest pain threshold correlated negatively with DHEA-S (r=-0.42, p=0.008).
We showed for the first time that sensitivity to thermal pain in women is dependent on DHEA-S and on cortisol/DHEA(S) ratio in patients with AN.
神经性厌食症（AN）患者由于性激素水平较低且一直被描述为痛阈升高，是激素水平变化与疼痛感知之间关系的天然模型。由于已知肾上腺应激类固醇激素（皮质醇和脱氢表雄酮）在AN患者中也会发生变化（且有共同前体），我们的研究旨在分析这些激素与AN患者及健康对照女性疼痛感知之间的关联。
对20名经DSM-IV诊断的AN患者和21名健康女性测量了对辐射热刺激的痛阈潜伏期。于上午采集血样，检测血浆脱氢表雄酮（DHEA）、其硫酸共轭酯（DHEA-S）和皮质醇水平。
AN患者的热痛阈高于健康女性，且与DHEA水平呈负相关，与皮质醇/DHEA（S）比值呈正相关。健康女性中未发现热痛与激素之间存在显著相关性。若将两组合并，静息痛阈与DHEA-S呈负相关（r = -0.42，p = 0.008）。
我们首次表明，女性对热痛的敏感性取决于AN患者的DHEA-S和皮质醇/DHEA（S）比值。
