Coiro V, Volpi R, Marchesi C, De Ferri A, d'Amato L, Caffarri G, Davolio M, Rossi E, Caffarra P, Chiodera P
Department of Internal Medicine, School of Medicine, University of Parma, Italy.
Biol Psychiatry. 1994 Jan 1;35(1):36-41. doi: 10.1016/0006-3223(94)91165-7.
The circadian variations in thyroid-stimulating hormone (TSH) secretion, with particular attention to the nocturnal serum TSH surge and the TSH response to thyrotropin releasing hormone (TRH), were measured in seven patients with seasonal affective disorder (SAD) and in eight normal controls. Both patients with SAD and normal controls were tested in fall/winter, when patients were suffering depressive symptoms, and in spring/summer, when patients were euthymic. The TRH tests were performed in the morning. In all tests, the mean peak TSH response to TRH was significantly lower in the patients with SAD than in the normal controls. No significant differences were observed in either group between spring/summer and fall/winter tests. At both periods, patients with SAD showed normal TSH levels in the morning, but did not experience a nocturnal TSH surge. In this group, morning and night TSH levels were similar. In contrast, normal controls showed significantly higher TSH levels at night than in the morning. Serum-free thyroid hormone levels were in the normal range in all subjects. Morning and night serum cortisol levels and 24-hour urinary cortisol concentrations were similar in all subjects. These data show that the secretion of TSH is impaired in SAD, regardless of the phase of the psychiatric disease. The low TSH response to TRH in the presence of normal serum thyroid hormone levels and the lack of the TSH nocturnal surge suggest that patients with SAD might be affected by mild central hypothyroidism.
对7例季节性情感障碍（SAD）患者和8名正常对照者的促甲状腺激素（TSH）分泌的昼夜变化进行了测量，特别关注夜间血清TSH峰值以及TSH对促甲状腺激素释放激素（TRH）的反应。SAD患者和正常对照者均在秋冬季节（此时患者出现抑郁症状）以及春夏季节（此时患者心境正常）接受测试。TRH测试在上午进行。在所有测试中，SAD患者对TRH的平均TSH峰值反应均显著低于正常对照者。在春夏和秋冬测试之间，两组均未观察到显著差异。在两个时期，SAD患者上午的TSH水平均正常，但未出现夜间TSH峰值。在该组中，早晚TSH水平相似。相比之下，正常对照者夜间的TSH水平显著高于上午。所有受试者的血清游离甲状腺激素水平均在正常范围内。所有受试者的早晚血清皮质醇水平和24小时尿皮质醇浓度均相似。这些数据表明，无论精神疾病处于何阶段，SAD患者的TSH分泌均受损。在血清甲状腺激素水平正常的情况下，TSH对TRH的反应较低，且缺乏TSH夜间峰值，这表明SAD患者可能受到轻度中枢性甲状腺功能减退的影响。
