Adriaanse R, Brabant G, Endert E, Wiersinga W M
Department of Endocrinology, University of Amsterdam, The Netherlands.
J Clin Endocrinol Metab. 1993 Jul;77(1):205-9. doi: 10.1210/jcem.77.1.8325943.
Pulsatile and nocturnal TSH secretion was investigated in 16 healthy controls (group A) and 19 patients with untreated pituitary disease [7 were euthyroid without suprasellar extension (group B), 6 were euthyroid with suprasellar extension (group C) of pituitary lesions, and 6 were hypothyroid with or without suprasellar extension (group D)]. Pulse analysis was performed using Desade and Cluster algorithms. No changes were observed among groups A-D in mean 24-h TSH pulse amplitude [values given as mean +/- SD; Desade, 0.4 +/- 0.2 vs. 0.7 +/- 0.4 vs. 0.6 +/- 0.4 vs. 0.5 +/- 0.2 mU/L (P = NS); Cluster, 0.4 +/- 0.2 vs. 0.7 +/- 0.4 vs. 0.5 +/- 0.3 vs. 0.4 +/- 0.2 mU/L (P = NS)] or in the mean 24-h TSH pulse frequency (approximately 10 pulses/24 h). The mean 24-h TSH concentration was highly correlated to the mean 24-h TSH pulse amplitude in controls (r = 0.93; P < 0.001) and patients (r = 0.63; P < 0.01), but not to the mean 24-h TSH pulse frequency. The nocturnal TSH surge was similar in controls and euthyroid patients without suprasellar extension (group A, 1.0 +/- 0.6; group B, 1.3 +/- 1.3 mU/L; P = NS), but was decreased in euthyroid patients with suprasellar extension (group C, 0.3 +/- 1.0 mU/L; P < 0.05) and hypothyroid patients (group D, 0.4 +/- 0.4 mU/L; P < 0.05). The decreased nocturnal TSH surge was associated with a loss of the usual nocturnal increase in TSH pulse amplitude, whereas the usual nocturnal increase in TSH pulse frequency was maintained. In conclusion, 1) mean 24-h TSH pulse amplitude and frequency are unchanged in untreated patients with pituitary disease; and 2) patients with central hypothyroidism as well as euthyroid patients with suprasellar extension of pituitary lesions had a decreased nocturnal TSH surge associated with a loss of the usual nocturnal increase in TSH amplitude, but not TSH pulse frequency.
对16名健康对照者（A组）和19例未经治疗的垂体疾病患者进行了促甲状腺激素（TSH）的脉冲式及夜间分泌情况研究[7例甲状腺功能正常且无鞍上扩展（B组），6例甲状腺功能正常且垂体病变有鞍上扩展（C组），6例甲状腺功能减退且有或无鞍上扩展（D组）]。使用德萨德算法和聚类算法进行脉冲分析。A - D组之间，24小时平均TSH脉冲幅度无变化[数值以平均值±标准差表示；德萨德算法，0.4±0.2 vs. 0.7±0.4 vs. 0.6±0.4 vs. 0.5±0.2 mU/L（P = 无显著性差异）；聚类算法，0.4±0.2 vs. 0.7±0.4 vs. 0.5±0.3 vs. 0.4±0.2 mU/L（P = 无显著性差异）]，24小时平均TSH脉冲频率也无变化（约10次脉冲/24小时）。24小时平均TSH浓度与对照组（r = 0.93；P < 0.001）和患者组（r = 0.63；P < 0.01）的24小时平均TSH脉冲幅度高度相关，但与24小时平均TSH脉冲频率无关。对照组和无鞍上扩展的甲状腺功能正常患者夜间TSH峰值相似（A组，1.0±0.6；B组，1.3±1.3 mU/L；P = 无显著性差异），但有鞍上扩展的甲状腺功能正常患者（C组，0.3±1.0 mU/L；P < 0.05）和甲状腺功能减退患者（D组，0.4±0.4 mU/L；P < 0.05）的夜间TSH峰值降低。夜间TSH峰值降低与TSH脉冲幅度通常的夜间增加消失有关，而TSH脉冲频率的通常夜间增加得以维持。总之，1）未经治疗的垂体疾病患者24小时平均TSH脉冲幅度和频率无变化；2）中枢性甲状腺功能减退患者以及垂体病变有鞍上扩展的甲状腺功能正常患者夜间TSH峰值降低，与TSH幅度通常的夜间增加消失有关，但与TSH脉冲频率无关。
