Laudat M H, Guilhaume B, Blot P, Fournier C, Giauque J P, Luton J P
Laboratoire d'hormonologie, Groupe Hospitalier Cochin - Baudelocque, Paris.
Ann Endocrinol (Paris). 1987;48(4):334-8.
The pattern of cortisol and testosterone levels during the normal pregnancy was investigated by measuring these hormones in the same 19 healthy pregnant women at 11th to 19th, 24th to 29th and 34th to 39th week post amenorrhea. We noted the well-known increase in total plasma cortisol and testosterone, due to the elevated concentration of their transport protein, i.e., Corticosteroid Binding Globulin (CBG) and Testosterone Estradiol Binding Globulin (TeBG), consecutive to the increase in plasma oestrogens. Morning (8h) and evening salivary cortisol (20 h) values, which are a good reflect of free plasma cortisol, were found increased since the second trimester of pregnancy, with a conserved circadian cycle. 24 h urinary free cortisol was slightly increased since the first trimester, yet remaining within the normal range; in the late pregnancy it reached sometimes higher levels. "Vesperal" urinary cortisol measured on a collected urine sample between 20 h and 24 h was higher in pregnant women since the beginning of pregnancy as compared to that of non pregnant women. Levels of salivary free testosterone measured in a few patients appeared similar to that of non-pregnant controls. We also report the data obtained in two pregnant women with Cushing's syndrome due to an adrenocortical carcinoma which showed a strong elevation of urinary and salivary free cortisol while a pregnant woman with a luteoma had a lower level as compared to normal pregnant. Moreover these three patients had a marked increase in free salivary testosterone opposite to normal pregnant women.
通过在19名健康孕妇停经后第11至19周、第24至29周和第34至39周测量皮质醇和睾酮水平,研究了正常孕期这些激素的变化模式。我们注意到,由于血浆雌激素增加后其转运蛋白即皮质类固醇结合球蛋白(CBG)和睾酮雌二醇结合球蛋白(TeBG)浓度升高,血浆总皮质醇和睾酮出现了众所周知的增加。反映游离血浆皮质醇水平的早晨(8时)和晚上唾液皮质醇(20时)值自妊娠中期起升高,昼夜节律周期保持不变。24小时尿游离皮质醇自妊娠早期起略有升高,但仍在正常范围内;妊娠晚期有时会达到更高水平。与非孕妇相比,孕妇在20时至24时采集的尿液样本中测得的“夜间”尿皮质醇自妊娠开始就更高。少数患者测得的唾液游离睾酮水平与非孕对照组相似。我们还报告了两名因肾上腺皮质癌导致库欣综合征的孕妇的数据,她们的尿游离皮质醇和唾液游离皮质醇水平显著升高,而一名患有黄体瘤的孕妇与正常孕妇相比水平较低。此外,这三名患者唾液游离睾酮水平与正常孕妇相反,显著升高。