Brismar K, Werner S, Thorén M, Wetterberg L
J Endocrinol Invest. 1985 Apr;8(2):91-5. doi: 10.1007/BF03350653.
The metyrapone-test was used to study the influence of pituitary-adrenal activity on the pineal function in man. We recorded in blood the circadian rhythmicity of melatonin, ACTH and cortisol and the excretion of melatonin, cortisol and Porter-Silber chromogens in urine before, during and after the administration of 750 mg metyrapone every 4 h during 24 h in two healthy volunteers and in two patients with asymptomatic, moderate hyperparathyroidism and a prolactin-secreting microadenoma, respectively. The present study confirmed our previous report on an increased excretion of melatonin per 24 h and per mmol creatinine during the administration of metyrapone. The excretory maximum preceded the maximal ACTH-adrenal response. Serum melatonin remained unchanged during the administration of metyrapone. A second finding was depressed serum melatonin the night after the test in the subjects with the most marked ACTH-cortisol response following the metyrapone-test indicating suppression of melatonin secretion when ACTH-cortisol secretions were increased. A third finding was a late increase in diuresis appearing the day after metyrapone-administration while glomerular filtration rates did not show significant alterations. Thus, it is shown that the metyrapone-induced cortisol inhibition stimulates both ACTH and melatonin secretion, while high ACTH and cortisol levels are accompanied by reduced S-melatonin levels.
甲吡酮试验用于研究垂体-肾上腺活动对人体松果体功能的影响。我们在两名健康志愿者以及分别患有无症状中度甲状旁腺功能亢进和泌乳素分泌型微腺瘤的两名患者中，记录了每4小时给予750毫克甲吡酮，持续24小时期间及之后，血液中褪黑素、促肾上腺皮质激素（ACTH）和皮质醇的昼夜节律，以及尿液中褪黑素、皮质醇和波特-西尔伯色素原的排泄情况。本研究证实了我们之前的报告，即甲吡酮给药期间每24小时和每毫摩尔肌酐的褪黑素排泄量增加。排泄峰值先于ACTH-肾上腺的最大反应。甲吡酮给药期间血清褪黑素保持不变。第二个发现是，在甲吡酮试验后ACTH-皮质醇反应最明显的受试者中，试验当晚血清褪黑素降低，表明ACTH-皮质醇分泌增加时褪黑素分泌受到抑制。第三个发现是甲吡酮给药后第二天出现利尿后期增加，而肾小球滤过率未显示明显变化。因此，研究表明甲吡酮诱导的皮质醇抑制会刺激ACTH和褪黑素分泌，而高ACTH和皮质醇水平伴随着血清褪黑素水平降低。
