通过唾液类固醇监测上腺功能缺陷:试点研究
Lorenzo Tucci1,2, Flaminia Fanelli2,3, Ilaria Improta1,2
1Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, 40138 Bologna, Italy.
European journal of endocrinology
|April 4, 2024
概括
对上腺功能不全 (AI) 的葡萄糖皮质醇替代疗法 (GRTs) 通常会导致过度暴露,影响生活质量. 唾液皮质醇和皮质素节奏可以帮助监测GRT的有效性,并确定最佳的治疗策略.
科学领域:
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
- 生物化学 生物化学
背景情况:
- 上腺功能不全 (AI) 需要葡萄糖皮质醇替代疗法 (GRT).
- 目前的GRT缺乏足够的生化标志物来评估恢复正常葡萄皮质激素节律和暴露的有效性.
- 白天唾液皮质醇 (SalF) 和皮质素 (SalE) 节律为GRT监测提供了潜在的标志物.
研究的目的:
- 描述各种GRT上AI患者的日间SalF和SalE节奏.
- 分析唾液衍生的参数与生活质量问卷之间的关联.
- 为了比较不同GRT在模仿生理性葡萄糖皮质激素暴露方面的有效性.
主要方法:
- 从07:00到23:00收集了9个唾液样本,这些样本来自对照对象 (n=28) 和接受皮质 (HC),酸皮质 (CA) 或双释放皮质 (DRHC-od/td) 的AI患者.
- 使用液体染色学-质谱学测量SalE和SalF,并计算曲线下的面积 (AUC).
- 通过验证问卷和分析多重回归的预测因素来评估生活质量.
主要成果:
- 与对照组相比,所有GRT都导致了早晨的葡萄糖皮质激素过度暴露.
- HC,CA和DRHC-td在下午和晚上显示过度暴露.
- 唾液参数,特别是午后早期的Z分数 (AUC14:00-16:00),显著预测了问卷分数.
结论:
- 目前没有任何GRT可以完美模仿正常的葡萄糖皮质激素节律和暴露.
- SalE,SalF和Z分数是监测和比较GRT的有价值的标记.
- 在下午早些时候过度暴露于葡萄糖皮质激素与抑郁症状,生活质量和睡眠质量下降有关.
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