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循环类固醇与耳鸣呈负相关。

Circulating steroids negatively correlate with tinnitus.

作者信息

Chrbolka Pavel, Palúch Zoltán, Hill Martin, Alušík Štefan

机构信息

Department of Otorhinolaryngology, Thomayer Hospital, Czech Republic.

Institute of Pharmacology, 2nd Faculty of Medicine, Charles University in Prague, Czech Republic.

出版信息

Steroids. 2017 Jul;123:37-42. doi: 10.1016/j.steroids.2017.04.004. Epub 2017 Apr 25.

Abstract

While not a disease entity in itself; symptoms of tinnitus (from Latin tinnio - clink) accompany a number of diseases. Tinnitus prevalence increases with age, deteriorates one's quality of life, and may even result in suicidal behavior. Tinnitus develops in response to a variety of risk factors, otoxic substances, noise exposure, hearing disorders, and psychological alterations. Tinnitus is closely related to mood, depression, and psychological state. In the present study, we focused on alterations of the steroid metabolome and particularly neuroactive, neuroprotective, and immunomodulatory steroids in patients with tinnitus. The study group consisted of 28 patients without evidence of an organic cause of tinnitus as well as without associated diseases or the effect of ototoxic medications. All patients underwent a complete audiological assessment and laboratory tests including routine biochemical markers and quantification of circulating steroids using gas chromatography/mass spectrometry and immunoassays. To rule out a pathology in the cerebellopontine angle area, CT scan or MRI were performed. To diagnose stem lesions, evoked potentials were also measured. Pearson's correlations and multivariate regression were used to assess any links between tinnitus intensity and frequency on the one hand, and steroid levels on the other. Results indicated a significant and consistent negative correlation between tinnitus indices and intensity of adrenal steroidogenesis. The circulating steroid metabolome including hormones and neuroactive, neuroprotective, and immunomodulatory steroids negatively correlates with the degree of tinnitus due to hypothalamo-pituitary-adrenal axis malfunction. Our results may help explain the pathophysiology of tinnitus and improve its diagnosis. However, further studies are needed to verify our postulation.

摘要

耳鸣本身并非一种疾病实体;耳鸣(源自拉丁语tinnio - 叮当声)症状伴随多种疾病出现。耳鸣患病率随年龄增长而增加,会降低人的生活质量,甚至可能导致自杀行为。耳鸣是由多种风险因素、耳毒性物质、噪声暴露、听力障碍和心理变化引起的。耳鸣与情绪、抑郁和心理状态密切相关。在本研究中,我们重点关注耳鸣患者类固醇代谢组的变化,特别是具有神经活性、神经保护和免疫调节作用的类固醇。研究组由28名患者组成,这些患者没有耳鸣的器质性病因证据,也没有相关疾病或耳毒性药物的影响。所有患者均接受了全面的听力学评估和实验室检查,包括常规生化指标以及使用气相色谱/质谱联用和免疫测定法对循环类固醇进行定量分析。为排除桥小脑角区病变,进行了CT扫描或MRI检查。为诊断脑干病变,还测量了诱发电位。使用Pearson相关性分析和多元回归分析来评估耳鸣强度和频率与类固醇水平之间的任何关联。结果表明,耳鸣指标与肾上腺类固醇生成强度之间存在显著且一致的负相关。包括激素以及具有神经活性、神经保护和免疫调节作用的类固醇在内的循环类固醇代谢组与下丘脑 - 垂体 - 肾上腺轴功能障碍导致的耳鸣程度呈负相关。我们的结果可能有助于解释耳鸣的病理生理学并改善其诊断。然而,需要进一步研究来验证我们的假设。

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