头发皮质醇和皮质醇动态的变化在慢性病中
Laura Boswell1,2,3, Arturo Vega-Beyhart2, Miquel Blasco4,5,6
1Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain.
Frontiers in endocrinology
|April 19, 2024
概括
头发皮质醇 (HC) 不反映慢性病 (CKD) 中的长期下丘脑-垂体-上腺 (HPA) 轴变化. 唾液皮质醇和甲抑制测试显示,慢性病患者的HPA轴发生变化.
科学领域:
- 内分泌学 在内分泌学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 代谢医学是一种代谢医学.
背景情况:
- 慢性病 (CKD) 与代谢性并发症和潜在的下丘脑-垂体-上腺 (HPA) 轴变化有关.
- 经典的HPA轴测试和头发皮质醇 (HC) 对皮质醇暴露和功能提供了不同的见解.
研究的目的:
- 在慢性病 (CKD) 患者中,将头发皮质醇 (HC) 与标准HPA轴测试进行比较.
- 评估HPA轴功能与CKD中的脏和心脏代谢状态之间的关联.
主要方法:
- 一项涉及48名患有CKDI-IV阶段的患者和24名匹配健康对照 (CTR) 的横截面研究.
- 评估代谢综合征特征,身体组成和HPA轴功能,使用唾液皮质醇,24小时无尿皮质醇 (24-h UFC),德克萨梅他抑制试验 (DST) 和头发皮质醇 (HC).
主要成果:
- 慢性病患者表现出HPA轴功能的改变,包括午间时间后皮质醇抑制降低,中午唾液皮质醇增加,晚期24小时UFC降低.
- 在DST后的皮质醇与估计的淋巴细胞过率 (eGFR) 相反相关,并且独立地与eGFR <30mL/min/m2.2相关.
- 头发皮质醇 (HC) 与内脏脂肪组织 (VAT) 相相关,而DST后的皮质醇和VAT与BMI相相关,但HC没有反映CKD的长期HPA轴变化.
结论:
- 在CKD患者中,唾液皮质醇节律和HPA轴动态的逐渐改变发生.
- 长期暴露于皮质醇,根据毛皮质醇 (HC) 评估,并没有显示CKD的显著变化.
- 需要进一步的研究来阐明临床意义和病理生理机制,将HPA参数,身体组成和损伤联系起来.
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