在患有轻度自主皮质醇分泌的患者中,类固醇分析和循环皮质醇分泌:一个横截面研究
Jasmine Saini1, Sumitabh Singh1,2, Andreas Ebbehoj3
1Division of Endocrinology and Metabolism, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA.
The Journal of clinical endocrinology and metabolism
|July 9, 2024
概括
患有轻度自主皮质醇分泌 (MACS) 的患者表现出改变的类固醇生产,具有更高的葡萄皮质醇和雄激素,并增加了夜间的类固醇释放. 这项研究揭示了MACS患者类固醇代谢的关键差异.
科学领域:
- 内分泌学 在内分泌学.
- 代谢学 代谢学 代谢学
- 临床化学 临床化学
背景情况:
- 轻度自主皮质醇分泌 (MACS) 被定义为超出1.8μg/dL的后甲皮质醇水平.
- 有限的数据存在关于昼夜类固醇分泌模式和MACS患者的综合类固醇代谢.
研究的目的:
- 在被诊断为MACS的患者中全面分析24小时尿中类固醇代谢组.
- 为了研究尿液类固醇特征和血清皮质醇度的昼夜变化,将MACS患者与匹配的参考受试者进行比较.
主要方法:
- 在2018年至2023年期间在专业推中心进行的一项横截面研究.
- 包括MACS患者和年龄,性别,BMI和更年期状态匹配的参考个体.
- 使用高分辨率质谱测量分析了25种类固醇的24小时尿液采集 (白天和夜间);在一个子组中测量了血清皮质醇.
主要成果:
- 在MACS患者 (n=72) 中,24小时中位数较低的雄激素 (2084比3283μg/24h) 和较高的葡萄糖皮质体 (15754比12936μg/24h) 显著降低,导致葡萄糖皮质体/雄激素比率升高 (8.7比3.9).
- 患有MACS的患者表现出降低的类固醇白天/夜间比率,这表明与参考人群相比,夜间类固醇产量比例较高.
- 虽然24小时血清皮质醇AUC相似,但晚上平均总和自由皮质醇水平在MACS患者中显著更高.
结论:
- 患有MACS的个体表现出明显的尿路类固醇代谢组,其特点是不平衡的葡萄糖皮质醇与雄激素的比率.
- 一个关键的发现是,MACS患者的相对夜间类固醇产量增加的证据,这表明昼夜类固醇分泌模式受到干扰.
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