Allain T J, Bearn J A, Coskeran P, Jones J, Checkley A, Butler J, Wessely S, Miell J P
Department of Medicine, Kings College School of Medicine and Dentistry, London, United Kingdom.
Biol Psychiatry. 1997 Mar 1;41(5):567-73. doi: 10.1016/s0006-3223(96)00074-1.
Chronic fatigue syndrome (CFS) is characterized by severe physical and mental fatigue of central origin. Similar clinical features may occur in disorders of the hypothalamopituitary axis. The aim of the study was to determine whether patients with CFS have abnormalities of the growth hormone/insulinlike growth factor (GH-IGF) axis basally or following hypothalamic stimulation with insulin-induced hypoglycemia. We compared levels of GH, IGF-I, IGF-II, IGF-binding protein-1 (IGFBP-1), insulin, and C-peptide in nondepressed CFS patients and normal controls. We found attenuated basal levels of IGF-I (214 +/- 17 vs. 263.4 +/- 13.4 micrograms/L, p = .036) and IGF-II (420 +/- 19.8 vs. 536 +/- 24.3 micrograms/L, p = .02) in CFS patients and a reduced GH response to hypoglycemia (peak GH; 41.9 +/- 11.5 vs. 106.0 +/- 25.6 mU/L, p = .017). Insulin levels were higher (7.6 +/- 1.0 vs. 4.3 +/- 0.8 mU/L, p = .02) and IGFBP-1 levels were lower (19.7 +/- 4.6 vs. 43.2 +/- 2.7 mg/L, p = .004) in CFS patients compared with controls. This study provides preliminary data abnormalities of the GH-IGF axis in CFS. It is not apparent whether these changes are components of a primary pathological process or are acquired secondary to behavioral aspects of CFS such as reduced physical activity.
慢性疲劳综合征（CFS）的特征是源于中枢的严重身心疲劳。下丘脑 - 垂体轴紊乱可能出现类似的临床特征。本研究的目的是确定CFS患者在基础状态下或胰岛素诱导低血糖刺激下丘脑后生长激素/胰岛素样生长因子（GH - IGF）轴是否存在异常。我们比较了非抑郁CFS患者和正常对照者的GH、IGF - I、IGF - II、胰岛素样生长因子结合蛋白 - 1（IGFBP - 1）、胰岛素和C肽水平。我们发现CFS患者的IGF - I基础水平降低（214±17 vs. 263.4±13.4微克/升，p = 0.036），IGF - II基础水平降低（420±19.8 vs. 536±24.3微克/升，p = 0.02），对低血糖的GH反应降低（GH峰值；41.9±11.5 vs. 106.0±25.6 mU/L，p = 0.017）。与对照组相比，CFS患者的胰岛素水平更高（7.6±1.0 vs. 4.3±0.8 mU/L，p = 0.02），IGFBP - 1水平更低（19.7±4.6 vs. 43.2±2.7毫克/升，p = 0.004）。本研究提供了CFS患者GH - IGF轴异常的初步数据。目前尚不清楚这些变化是原发性病理过程的组成部分，还是继发于CFS行为方面（如体力活动减少）。
