Fujieda K, Reyes F I, Blankstein J, Faiman C
Am J Obstet Gynecol. 1980 Aug 15;137(8):962-5. doi: 10.1016/s0002-9378(16)32839-3.
In order to assess whether long-term low-dose glucocorticoid administration results in suppression of the hypothalamic-pituitary-adrenal (H-P-A) axis, we examined the response of plasma cortisol to insulin-induced hypoglycemia in 23 women treated with prednisone (5 mg/day) compared with that in 19 untreated women. Basal AM levels of plasma cortisol were unaffected (mean +/- SE, 11.6 +/- 0.9 versus 11.2 +/- 0.7 microgram/dl). The plasma cortisol increment at 609 minutes after insulin-induced hypoglycemia was significantly smaller in the treated group than in the untreated group (6.7 +/- 1.0 versus 11.6 +/- 1.2 microgram/dl, p less than 0.005). Thirteen of 23 women (56.5%) in the steroid-treated group compared to one of 19 (5.3%) in the untreated group, showed a rise in plasma cortisol of less than 6 microgram/dl at 60 minutes. Furthermore, a similar reduction in the increment of plasma cortisol was also found in a subset of 10 women tested both before and during prednisone treatment. These results indicate that the concept that low doses of glucocorticoids are free of suppressive effects on H-P-A function is not justified.
为了评估长期小剂量服用糖皮质激素是否会导致下丘脑 - 垂体 - 肾上腺（H - P - A）轴受抑制，我们检测了23名服用泼尼松（5毫克/天）的女性和19名未接受治疗的女性在胰岛素诱发低血糖后血浆皮质醇的反应。血浆皮质醇的基础上午水平未受影响（均值±标准误，分别为11.6±0.9与11.2±0.7微克/分升）。在胰岛素诱发低血糖后60分钟时，治疗组血浆皮质醇的增加值显著低于未治疗组（分别为6.7±1.0与11.6±1.2微克/分升，p＜0.005）。在接受类固醇治疗的23名女性中，有13名（56.5%）在60分钟时血浆皮质醇升高不到6微克/分升，而在未治疗的19名女性中仅有1名（5.3%）如此。此外，在10名在泼尼松治疗前和治疗期间均接受检测的女性亚组中，也发现血浆皮质醇增加值有类似降低。这些结果表明，低剂量糖皮质激素对H - P - A功能无抑制作用这一观点是不合理的。
