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[内源性库欣综合征和肢端肥大症患者的血清肌动蛋白水平:横断面病例对照研究]

[Serum Myokines Levels in Patients with Endogenous Cushing Syndrome and Acromegaly: Cross-Sectional Case−Control Study].

作者信息

Kolesnikova L I, Madaeva I M, Semenova N V, Osipova E V, Darenskaya M A

出版信息

Vestn Ross Akad Med Nauk. 2016;71(3):240-7. doi: 10.15690/vramn659.

Abstract

BACKGROUND

Myokines are produced and released by muscle cells in response to muscular contractions. Endogenous Cushing syndrome (CS) and acromegaly cause significant changes in muscle tissue leading to atrophy or hypertrophy. However, there is no data whether these endocrine abnormalities influence myokine secretion.

AIMS

To evaluate serum levels of myostatin, interleukin-6 (IL6) and irisin in patients with CS and acromegaly.

MATERIALS AND METHODS

Fasting serum samples were taken and stored in aliquot at ≤-20°C from consecutive subjects with clinically evident and biochemically confirmed active CS, acromegaly and healthy volunteers matched by age, sex and body mass index (BMI). Commercially available kits were used to assay serum myokine levels. Grip strength was measured by a dynamometer. Insulin-like growth factor-1 (IGF1) was measured by immunochemiluminescence assay (Liaison), twenty-four hours urine free cortisol (24hUFC) ― by immunochemiluminescence assay (Vitros ECi), salivary free cortisol ― by electrochemiluminescence assay (Cobas). One-way ANOVA was utilized to assess the difference between groups.

RESULTS

We enrolled 88 subjects: 30 patients suffered from CS (group 1), 28 ― acromegaly (2) and 30 matched healthy controls (3) with no difference among the groups in sex, age and BMI (p=0.492, 0.062 and 0.174 respectively). Mean 24hUFC in subjects with CS and mean IGF1 in subjects with acromegaly were significantly higher as compared to other groups (p<0.001). Right-hand grip strength was lower in patients with CS as compared to both patients with acromegaly and healthy subjects (p=0.04). However, among these young adults we did not find statistically significant differences in measured myokines levels: irisin ― p=0.15; IL6 ― p=0.34; myostatin ― p=0.50. There was a significant correlation between myostatin and irisin in the whole group of people and in every separately analyzed subset of patients (p<0.001), but no correlation was found between any measured myokines and 24hUFC or IGF1.

CONCLUSIONS

Hypercortisolism or supraphysiological IGF1 levels do not significantly influence serum levels of myostatin, IL6 and irisin in young adults.

摘要

背景

肌动蛋白是肌肉细胞在肌肉收缩时产生并释放的。内源性库欣综合征(CS)和肢端肥大症会导致肌肉组织发生显著变化,进而导致萎缩或肥大。然而,尚无数据表明这些内分泌异常是否会影响肌动蛋白的分泌。

目的

评估CS和肢端肥大症患者血清中肌肉生长抑制素、白细胞介素-6(IL6)和鸢尾素的水平。

材料与方法

采集连续的临床症状明显且经生化确诊的活动性CS患者、肢端肥大症患者以及年龄、性别和体重指数(BMI)相匹配的健康志愿者的空腹血清样本,并在≤-20°C下分装保存。使用市售试剂盒检测血清肌动蛋白水平。用测力计测量握力。通过免疫化学发光法(Liaison)检测胰岛素样生长因子-1(IGF1),通过免疫化学发光法(Vitros ECi)检测24小时尿游离皮质醇(24hUFC),通过电化学发光法(Cobas)检测唾液游离皮质醇。采用单因素方差分析评估组间差异。

结果

我们纳入了88名受试者:30例CS患者(第1组),28例肢端肥大症患者(第2组)和30名匹配的健康对照者(第3组),三组在性别、年龄和BMI方面无差异(分别为p = 0.492、0.062和0.174)。与其他组相比,CS患者的平均24hUFC和肢端肥大症患者的平均IGF1显著更高(p < 0.001)。与肢端肥大症患者和健康受试者相比,CS患者的右手握力较低(p = 0.04)。然而,在这些年轻人中,我们未发现所测肌动蛋白水平存在统计学显著差异:鸢尾素——p = 0.15;IL6——p = 0.34;肌肉生长抑制素——p = 0.50。在整组人群以及每个单独分析的患者亚组中,肌肉生长抑制素与鸢尾素之间存在显著相关性(p < 0.001),但在所测的任何肌动蛋白与24hUFC或IGF1之间未发现相关性。

结论

高皮质醇血症或超生理水平的IGF1对年轻人血清中肌肉生长抑制素、IL6和鸢尾素的水平无显著影响。

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