Boettcher Claudia, Hartmann Michaela F, Zimmer Klaus-Peter, Wudy Stefan A
Division of Paediatric Endocrinology and Diabetology, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany.
Steroid Research and Mass Spectrometry Unit, Centre of Child and Adolescent Medicine, Justus Liebig University Giessen, Giessen, Germany.
Front Endocrinol (Lausanne). 2017 Jul 18;8:171. doi: 10.3389/fendo.2017.00171. eCollection 2017.
Physicians' daily work is accompanied by emotional and physical stress, and 24-h shifts are considered to be a major stressor. Effects of stressors on the hypothalamic-pituitary-adrenal (HPA) axis can be evaluated by estimating the glucocorticoid excretion in urine samples. We characterized the impact of a 24-h working period on the urinary glucocorticoid excretion of physicians and focused on gender differences. 10 females and 12 male physicians collected 24-h urine samples during a 24-h shift ("on-duty") and on a free weekend ("off-duty") that were analyzed by gas chromatography-mass spectrometry. Urinary glucocorticoid excretion rates (GERs) were assessed by addition of the 24-h excretion rates per square meter body surface area for the seven major urinary cortisol and cortisone metabolites. Women showed generally lower glucorticoid excretion rates compared to men. Only male physicians had increased GERs on duty compared to off duty. As a measure of change between being on duty and off duty, the ratio GERs on duty/GERs off duty was significantly higher in males than in females. Thus, the 24-h shift stress factor generates diverging results between female and male subjects with activation of the HPA axis primarily in male physicians.
医生的日常工作伴随着情绪和身体上的压力，24小时轮班被认为是一个主要的压力源。应激源对下丘脑-垂体-肾上腺（HPA）轴的影响可以通过估计尿液样本中的糖皮质激素排泄来评估。我们描述了24小时工作时段对医生尿中糖皮质激素排泄的影响，并关注性别差异。10名女性医生和12名男性医生在24小时轮班期间（“值班”）和一个自由的周末（“非值班”）收集了24小时尿液样本，这些样本通过气相色谱-质谱法进行分析。通过将七种主要尿皮质醇和可的松代谢物每平方米体表面积的24小时排泄率相加来评估尿糖皮质激素排泄率（GERs）。与男性相比，女性的糖皮质激素排泄率总体较低。只有男性医生值班时的GERs比非值班时有所增加。作为值班和非值班之间变化的一个衡量指标，男性的值班GERs/非值班GERs比值显著高于女性。因此，24小时轮班压力因素在男性和女性受试者中产生了不同的结果，HPA轴的激活主要发生在男性医生身上。
