Hirschfeld U, Moreno-Reyes R, Akseki E, L'Hermite-Balériaux M, Leproult R, Copinschi G, Van Cauter E
Department of Medicine, University of Chicago, Illinois 60637, USA.
J Clin Endocrinol Metab. 1996 Sep;81(9):3270-7. doi: 10.1210/jcem.81.9.8784082.
It is well known that TSH secretion is modulated by sleep and circadian rhythmicity, but effects of abrupt shifts of the sleep-wake and dark-light cycles such as occur in jet lag and shift work have not been investigated. The present study examines alterations in the 24-h profiles of plasma TSH and thyroid hormones following an 8-h advance shift achieved without enforcing prolonged sleep deprivation. The effects of bright light exposure or sleep facilitation with zolpidem were investigated in separate studies performed in the same subjects. Each study involved blood sampling at 20-min intervals for 68 h and included a baseline period with dim light during waking hours and 2300-0700 h bedtimes in total darkness. The 8-h shift was achieved by advancing bedtimes to 1500-2300 h. In the course of adaptation to the shift, TSH levels increased progressively in all three studies because daytime sleep failed to inhibit TSH and nighttime wakefulness was associated with large TSH elevations. The overall elevation of TSH tended to be paralleled by a small increase in T3, but not free T4, levels. In the absence of treatment, mean TSH levels following awakening from the second shifted sleep were more than 2-fold higher than during the same time interval following normal nocturnal sleep (2.10 +/- 0.22 mU/L vs. 1.04 +/- 0.14 mU/L; n = 8, P < 0.001). Bright light exposure limited the overall increase of TSH, and mean TSH levels at the end of the study were lower than in the absence of treatment (P < 0.03). Treatment with zolpidem during the first shifted night limited the overall increase in TSH levels during the following waking period (P < 0.05), but the beneficial effect was no longer significant following the second shifted night. Thus, the jet lag syndrome may be associated with a prolonged elevation of peripheral TSH levels that may be limited by treatment with bright light exposure or hypnotic facilitation of sleep.
众所周知，促甲状腺激素（TSH）的分泌受睡眠和昼夜节律调节，但诸如时差反应和轮班工作中出现的睡眠 - 觉醒及明暗周期的突然变化的影响尚未得到研究。本研究在未强制长期睡眠剥夺的情况下，考察了8小时提前移位后血浆TSH和甲状腺激素24小时谱的变化。在对同一受试者进行的单独研究中，考察了强光照射或使用唑吡坦促进睡眠的效果。每项研究包括每隔20分钟采集一次血样，共68小时，包括一个基线期，清醒时处于暗光环境，总睡眠时间为23:00至07:00，处于完全黑暗中。通过将睡眠时间提前至15:00至23:00实现8小时的移位。在适应移位的过程中，在所有三项研究中TSH水平逐渐升高，因为白天睡眠未能抑制TSH，夜间清醒与TSH大幅升高相关。TSH的总体升高往往伴随着T3水平的小幅升高，但游离T4水平未升高。在未进行治疗的情况下，从第二次移位睡眠中醒来后的平均TSH水平比正常夜间睡眠后相同时间间隔内高出2倍多（2.10±0.22 mU/L对1.04±0.14 mU/L；n = 8，P < 0.001）。强光照射限制了TSH的总体升高，研究结束时的平均TSH水平低于未治疗时（P < 0.03）。在第一个移位夜间使用唑吡坦治疗限制了随后清醒期TSH水平的总体升高（P < 0.05），但在第二个移位夜间后有益效果不再显著。因此，时差反应综合征可能与外周TSH水平的长期升高有关，强光照射或催眠促进睡眠的治疗可能会限制这种升高。
