Kallman Thomas F, Bäckryd Emmanuel
Pain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
Pain Rep. 2024 Sep 13;9(5):e1183. doi: 10.1097/PR9.0000000000001183. eCollection 2024 Oct.
Opioid treatment may affect endocrine measures in humans either through centrally or peripherally mediated mechanisms. There is a general lack of longitudinal studies examining endocrine measures in opioid-treated patients.
To longitudinally follow the levels of select endocrine measures in men and women with head and neck cancer for 1 year, who after having completed radiotherapy began tapering opioids.
This was a prospective, longitudinal, observational study. Testosterone and estradiol were measured in men and women, respectively. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), dehydroepiandrosterone sulfate (DHEAS), and prolactin were measured in both sexes. Women were grouped based on if premenopausal or postmenopausal. Samples were collected when opioid tapering started and at 1, 3, 6, and 12 months after tapering start. Daily opioid doses at the same time points were registered.
Twenty-five men and 12 women were followed for 12 months. In men, testosterone levels increased significantly during the first month after opioid tapering started ( < 0.001). Levels of testosterone, FSH, DHEAS, and prolactin changed significantly in men during the study period. A moderate correlation between opioid dose reduction and testosterone level increase in men aged ≤60 years was found ( = -0.577, 95% CI -0.854 to -0.044, = 0.039). In postmenopausal women (n = 10), levels of FSH and LH changed significantly during the study period.
Previously known effects of opioids on endocrine measures in humans seem to be reversible as select endocrine measures changed significantly in men and postmenopausal women after opioid tapering was initiated.
阿片类药物治疗可能通过中枢或外周介导机制影响人体内分泌指标。目前普遍缺乏对接受阿片类药物治疗患者的内分泌指标进行纵向研究。
对完成放疗后开始逐渐减少阿片类药物用量的头颈癌男性和女性患者的特定内分泌指标水平进行为期1年的纵向跟踪。
这是一项前瞻性、纵向观察性研究。分别对男性和女性测量睾酮和雌二醇。对两性均测量促卵泡激素（FSH）、促黄体生成素（LH）、硫酸脱氢表雄酮（DHEAS）和催乳素。根据绝经前或绝经后对女性进行分组。在开始逐渐减少阿片类药物用量时以及减量开始后1、3、6和12个月采集样本。记录相同时间点的每日阿片类药物剂量。
25名男性和12名女性被跟踪了12个月。在男性中，开始逐渐减少阿片类药物用量后的第一个月睾酮水平显著升高（<0.001）。在研究期间，男性的睾酮、FSH、DHEAS和催乳素水平发生了显著变化。在年龄≤60岁的男性中，发现阿片类药物剂量减少与睾酮水平升高之间存在中度相关性（=-0.577，95%CI -0.854至-0.044，=0.039）。在绝经后女性（n=10）中，FSH和LH水平在研究期间发生了显著变化。
阿片类药物对人体内分泌指标的已知影响似乎是可逆的，因为在开始逐渐减少阿片类药物用量后，男性和绝经后女性的特定内分泌指标发生了显著变化。
