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糖皮质激素在促甲状腺激素调节中的作用。

The role of glucocorticoids in the regulation of thyrotropin.

作者信息

Brabant A, Brabant G, Schuermeyer T, Ranft U, Schmidt F W, Hesch R D, von zur Mühlen A

机构信息

Department of Clinical Endorinology, Medizinische Hochschule, Hannover, FRG.

出版信息

Acta Endocrinol (Copenh). 1989 Jul;121(1):95-100. doi: 10.1530/acta.0.1210095.

Abstract

The potentially inhibitory action of endogenous or exogenous synthetic glucocorticoids on TSH secretion was investigated. Pulsatile and circadian TSH and cortisol rhythms were measured in healthy subjects (12 rhythms), but no correlation between the hormones could be detected. Acute stimulation of endogenous cortisol secretion by CRH tests (1 microgram/kg of ovine CRH) at 20.00 h in 9 healthy volunteers did not significantly alter the nightly increase in TSH. Chronic elevation of endogenous cortisol serum levels in patients with Cushing's disease revealed a heterogeneous pattern. In 2 patients serum TSH and thyroid hormone levels showed a normal 24-h rhythm, whereas the other 2 patients had low TSH serum levels. Acute treatment of 9 healthy volunteers with 0.5, 1 or 2 mg dexamethasone po at 23.00 h resulted in a significant dose-dependent suppression of mean basal TSH levels 9h later. Treatment with 30 mg of prednisone for 1 week in 7 patients with Crohn's disease did not influence basal TSH. The TSH response to TRH was only temporarily suppressed on day 3, but not on day 7 of treatment. The results suggest than under physiological conditions glucocorticoids have no regulatory influence on pulsatile and circadian TSH secretion.

摘要

研究了内源性或外源性合成糖皮质激素对促甲状腺激素(TSH)分泌的潜在抑制作用。在健康受试者中测量了促甲状腺激素和皮质醇的脉冲式及昼夜节律(12个节律),但未检测到激素之间的相关性。在9名健康志愿者中,于20:00时通过促肾上腺皮质激素释放激素(CRH)试验(1微克/千克羊CRH)急性刺激内源性皮质醇分泌,并未显著改变夜间促甲状腺激素的升高。库欣病患者内源性皮质醇血清水平的慢性升高呈现出异质性模式。在2例患者中,血清促甲状腺激素和甲状腺激素水平显示出正常的24小时节律,而另外2例患者的促甲状腺激素血清水平较低。9名健康志愿者于23:00时口服0.5、1或2毫克地塞米松进行急性治疗,9小时后导致平均基础促甲状腺激素水平出现显著的剂量依赖性抑制。7例克罗恩病患者用30毫克泼尼松治疗1周,未影响基础促甲状腺激素水平。促甲状腺激素对促甲状腺激素释放激素(TRH)的反应仅在治疗第3天暂时受到抑制,但在第7天未受抑制。结果表明,在生理条件下,糖皮质激素对促甲状腺激素的脉冲式和昼夜分泌没有调节作用。

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