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抑郁症患者生长激素的日间分泌过多

Diurnal hypersecretion of growth hormone in depression.

作者信息

Mendlewicz J, Linkowski P, Kerkhofs M, Desmedt D, Golstein J, Copinschi G, Van Cauter E

出版信息

J Clin Endocrinol Metab. 1985 Mar;60(3):505-12. doi: 10.1210/jcem-60-3-505.

Abstract

A 24-h profile of plasma GH concentrations was obtained together with polygraphic recordings of sleep in 16 men suffering from a major depressive disorder (8 unipolar and 8 bipolar) and in 8 age- and sex-matched normal men. None of the patients had any physical illness. All were studied after a drug-free period of at least 15 days. Blood was sampled every 15 min. The amount of GH released in every significant secretory spike was estimated using a computer program. Both unipolar and bipolar depressed patients secreted more GH than normal men (mean +/- SD, 441 +/- 189 micrograms/24 h for unipolar depressed men; 357 +/- 143 micrograms/24 h for bipolar depressed men vs. 172 +/- 101 micrograms/24 h for normal men (P less than 0.01). This hypersecretion occurred during waking hours rather than during sleep. The increase in daytime GH release was more marked in unipolar depressed patients. During sleep, depressed patients and normal men secreted similar amounts of GH despite an overall reduction in slow wave stages in depressed patients. An early sleep GH increase was found in all but one of the normal men, but was absent in seven of the eight unipolar depressed patients, who had, instead, a presleep increase in between 2100-0000 h. No consistent disturbance of the temporal association between sleep onset and GH secretion was found in bipolar depressed patients.

摘要

对16名患有重度抑郁症的男性(8名单相抑郁症患者和8名双相抑郁症患者)以及8名年龄和性别匹配的正常男性进行了研究,获取了他们24小时的血浆生长激素(GH)浓度曲线,并同步进行了睡眠多导记录。所有患者均无躯体疾病。所有患者在至少15天的停药期后接受研究。每15分钟采集一次血样。使用计算机程序估算每次显著分泌峰中释放的GH量。单相和双相抑郁症患者分泌的GH均多于正常男性(单相抑郁症男性的均值±标准差为441±189微克/24小时;双相抑郁症男性为357±143微克/24小时,而正常男性为172±101微克/24小时,P<0.01)。这种分泌过多发生在清醒时段而非睡眠期间。单相抑郁症患者白天GH释放的增加更为明显。在睡眠期间,尽管抑郁症患者的慢波睡眠阶段总体减少,但抑郁症患者和正常男性分泌的GH量相似。除一名正常男性外,其他所有正常男性均出现睡眠早期GH增加,但8名单相抑郁症患者中有7名未出现,而是在21:00至0:00之间出现睡前增加。双相抑郁症患者未发现睡眠开始与GH分泌之间的时间关联存在一致的紊乱。

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