Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy.
Service of Clinical Engineering, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy.
J Endocrinol Invest. 2021 Jul;44(7):1501-1513. doi: 10.1007/s40618-020-01457-5. Epub 2020 Oct 29.
To cope physical and/or psychological threats, the human body activates multiple processes, mediated by a close interconnection among brain, endocrine and inflammatory systems. The aim of the study was to assess the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes involvement after an acute stressful event (Emilia Romagna earthquake swarm) with a big data approach.
A retrospective, observational trial was performed, collecting all biochemical examinations regarding HPA and HPT axes performed in the same laboratory the year before and the year after the earthquake swarm (20-29 May 2012).
Comparing 2576 pre-earthquake to 3021 post-earthquake measurements, a cortisol serum level increase was observed (p < 0.001). Similar increase was evident for urinary free cortisol (p = 0.016), but not for adrenocorticotropic hormone (p = 0.222). The biochemical hypercortisolism incidence increased from 7.6 to 10.3% after earthquakes (p = 0.001). Comparing 68,456 pre-earthquake to 116,521 post-earthquake measurements, a reduction in thyroid-stimulating hormone (TSH) levels was evident (p = 0.018), together with an increase in free triiodothyronine and free thyroxine levels (p < 0.001 and p < 0.001). Moreover, a significant increase in altered TSH after earthquakes was registered considering the epicenter-nearest measurements (p < 0.001). No clinically relevant alterations were observed considering thyroid-specific autoantibodies.
A long-term HPA axis activation in the inhabitants of the earthquake-affected areas was highlighted for the first time. Moreover, an increased incidence of biochemical hypercortisolism emerged after earthquakes. We confirmed a recruitment of HPT axis after stressful events, together with increased incidence of altered TSH in the. Our big data study allowed to increase knowledge about the connection between external stressors and endocrine regulation.
为了应对身体和/或心理威胁，人体通过大脑、内分泌和炎症系统的紧密相互联系激活多种过程。本研究的目的是通过大数据方法评估急性应激事件（艾米利亚-罗马涅地震群）后下丘脑-垂体-肾上腺（HPA）和下丘脑-垂体-甲状腺（HPT）轴的参与情况。
进行了一项回顾性观察性试验，收集了地震群发生前后（2012 年 5 月 20 日至 29 日）同一家实验室进行的 HPA 和 HPT 轴的所有生化检查。
将 2576 次地震前测量值与 3021 次地震后测量值进行比较，发现血清皮质醇水平升高（p<0.001）。尿游离皮质醇也出现了类似的升高（p=0.016），但促肾上腺皮质激素没有（p=0.222）。地震后生化性皮质醇增多症的发生率从 7.6%增加到 10.3%（p=0.001）。将 68456 次地震前测量值与 116521 次地震后测量值进行比较，发现促甲状腺激素（TSH）水平降低（p=0.018），同时游离三碘甲状腺原氨酸和游离甲状腺素水平升高（p<0.001 和 p<0.001）。此外，考虑到震中附近的测量值，地震后发现 TSH 改变的发生率显著增加（p<0.001）。考虑到甲状腺特异性自身抗体，未观察到临床相关的改变。
首次强调了地震受灾地区居民的 HPA 轴长期激活。此外，地震后生化性皮质醇增多症的发生率增加。我们证实了应激事件后 HPT 轴的募集，以及异常 TSH 的发生率增加。我们的大数据研究增加了对外界应激源和内分泌调节之间联系的了解。
