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甲状腺激素和糖皮质激素作用下正常甲状腺功能男性的昼夜节律性和脉冲式促甲状腺激素分泌

Circadian and pulsatile thyrotropin secretion in euthyroid man under the influence of thyroid hormone and glucocorticoid administration.

作者信息

Brabant G, Brabant A, Ranft U, Ocran K, Köhrle J, Hesch R D, von zur Mühlen A

出版信息

J Clin Endocrinol Metab. 1987 Jul;65(1):83-8. doi: 10.1210/jcem-65-1-83.

Abstract

The inhibitory action of thyroid hormones (TH) and glucocorticoids on circadian and pulsatile TSH secretion was investigated in groups of five normal men by sampling blood every 10 min for 24 h (start, 1750 h). Serum TSH was measured by a sensitive immunoradiometric assay. Continuous infusion of 50 micrograms T3 or 250 micrograms T4 for 8 h (1900-0300 h) significantly suppressed serum TSH levels (T3, P less than 0.025; T4, P less than 0.05; by paired t test). Administration of 3 g sodium ipodate 7 h before TH infusion did not alter the TSH response to T3, but T4-dependent suppression was abolished. Pulsatile TSH secretion [basally, 5.8 +/- 1.3 (+/- SD) pulses/24 h, as analyzed by the PULSAR program; 6.8 +/- 1.9 by the Cluster program] was not significantly altered by any of the experimental conditions. The additional finding of blunting of the TSH response to TRH after TH alone or ipodate and T3 suggests a predominantly pituitary feedback action of TH exerted via conversion of T4 to T3. In contrast, bolus injections of 4 mg dexamethasone (dex) at 1900 and 2200 h abolished TSH pulses for at least 6 h (PULSAR, 6.6 +/- 1.6 pulses/24 h basally vs. 3.6 +/- 3.0 under dex; Cluster, 7.0 +/- 2.7 pulses/24 h basally vs. 1.6 +/- 1.6 under dex). Dex administration also resulted in a prompt, sustained, and significant suppression of basal TSH (P less than 0.0005). Together with a normal serum TSH response to TRH (in separate experiments 1, 9, and 19 h after dex administration), these data suggest that glucocorticoid feedback occurs at a suprapituitary level.

摘要

通过对五名正常男性进行分组研究,每10分钟采集一次血样,持续24小时(起始时间为1750时),来探究甲状腺激素(TH)和糖皮质激素对昼夜节律性及脉冲式促甲状腺激素(TSH)分泌的抑制作用。采用灵敏的免疫放射分析法定量测定血清TSH。连续8小时(1900 - 0300时)输注50微克T3或250微克T4可显著抑制血清TSH水平(T3,P < 0.025;T4,P < 0.05;配对t检验)。在输注TH前7小时给予3克碘番酸钠,并不改变TSH对T3的反应,但依赖T4的抑制作用被消除。脉冲式TSH分泌[基础状态下,经PULSAR程序分析为5.8 ± 1.3(±标准差)次脉冲/24小时;经Cluster程序分析为6.8 ± 1.9次脉冲/24小时]在任何实验条件下均无显著改变。单独给予TH或碘番酸钠及T3后,TSH对促甲状腺激素释放激素(TRH)反应减弱这一额外发现提示,TH主要通过将T4转化为T3对垂体发挥反馈作用。相比之下,在1900时和2200时静脉推注4毫克地塞米松(dex)可使TSH脉冲消失至少6小时(PULSAR程序分析,基础状态下为6.6 ± 1.6次脉冲/24小时,地塞米松作用下为3.6 ± 3.0次脉冲/24小时;Cluster程序分析,基础状态下为7.0 ± 2.7次脉冲/24小时,地塞米松作用下为1.6 ± 1.6次脉冲/24小时)。给予地塞米松还可迅速、持续且显著地抑制基础TSH水平(P < 0.0005)。结合血清TSH对TRH的正常反应(在单独实验中,地塞米松给药后1、9和19小时),这些数据表明糖皮质激素反馈发生在垂体以上水平。

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