Marakaki C, Papadimitriou D T, Papadopoulou A, Fretzayas A, Papadimitriou A
Third Department of Pediatrics, Attikon University Hospital, Athens, Greece.
Horm Res Paediatr. 2014;81(6):386-90. doi: 10.1159/000357268. Epub 2014 May 1.
In this study, we evaluated the diagnostic usefulness of oral L-dopa as a stimulatory agent for cortisol.
In 27 short children that were evaluated for possible growth hormone deficiency (GHD), the levels of serum GH and cortisol were determined after oral L-dopa administration and after i.m. glucagon administration. We defined cortisol concentrations >18 μg/dl (496 nmol/l) as adequate response. Peak GH concentration <10 ng/ml in both tests defined GHD.
Twenty-five out of the 27 children (93%) studied showed a normal cortisol response, i.e. a peak serum cortisol >18 μg/dl in the L-dopa test, whereas 19 children (70%) had a normal cortisol response after stimulation with glucagon. In the children with normal cortisol response in both tests, the mean peak serum cortisol concentration was 28.7 (SD 1.59) after L-dopa and 26.65 (SD 1.26) μg/dl after glucagon administration. There was no statistically significant difference in peak serum cortisol response to L-dopa between GH-deficient and GH-sufficient children [25.90 (SD 4.9) vs. 29.87 (SD 9.9) μg/dl, respectively].
These results clearly suggest that L-dopa administration is a potent stimulus for cortisol secretion at least in short children.
在本研究中，我们评估了口服左旋多巴作为皮质醇刺激剂的诊断效用。
在27名接受可能生长激素缺乏（GHD）评估的矮小儿童中，在口服左旋多巴给药后和肌肉注射胰高血糖素后测定血清GH和皮质醇水平。我们将皮质醇浓度>18μg/dl（496nmol/l）定义为充分反应。两项测试中生长激素峰值浓度<10ng/ml定义为GHD。
27名研究儿童中有25名（93%）显示皮质醇反应正常，即左旋多巴试验中血清皮质醇峰值>18μg/dl，而19名儿童（70%）在胰高血糖素刺激后皮质醇反应正常。在两项测试中皮质醇反应正常的儿童中，左旋多巴给药后血清皮质醇平均峰值浓度为28.7（标准差1.59），胰高血糖素给药后为26.65（标准差1.26）μg/dl。生长激素缺乏和生长激素充足的儿童之间，对左旋多巴的血清皮质醇峰值反应无统计学显著差异[分别为25.90（标准差4.9）和29.87（标准差9.9）μg/dl]。
这些结果清楚地表明，至少在矮小儿童中，给予左旋多巴是皮质醇分泌的有效刺激。
