葡萄糖皮质类药物治疗增加胆固醇在危急疾病期间可用性:对上腺和肌肉功能的影响
Lauren De Bruyn1, Arno Téblick1, Tim Van Oudenhove1
1Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, O&N1 Box 503, 3000, Leuven, Belgium.
Critical care (London, England)
|September 5, 2024
概括
葡萄糖皮质醇治疗改善了严重疾病中的胆固醇水平,但损害了上腺功能和肌肉再生. 这表明,在重症患者中,胆固醇可用性和整体康复之间存在权衡.
科学领域:
- 内分泌学 在内分泌学.
- 关键护理医学 关键护理医学
- 代谢研究研究 代谢研究
背景情况:
- 低胆固醇血症在危急疾病中很常见,原因不明.
- 增加胆固醇转化为皮质醇/皮质可能导致低胆固醇.
研究的目的:
- 调查葡萄糖皮质体治疗是否会影响严重疾病中的胆固醇水平和上腺/骨肌功能.
- 测试葡萄糖皮质醇降低皮质醇合成,改善胆固醇可用性的假设.
主要方法:
- 对人类患者数据的EPaNIC RCT (n=324) 的二次分析.
- 用皮或安慰剂治疗的败血症小鼠模型 (结和刺穿).
- 血/上腺皮质/肌纤维胆固醇的量化,上腺功能,肌肉特性和身体组成.
主要成果:
- 葡萄糖皮质体治疗增加了患者的HDL/LDL胆固醇.
- 在小鼠中,水皮质使皮质正常化,但导致上腺皮质炎症/亡和胆固醇水平恶化.
- 皮治疗降低了体质和水分含量,并抑制了败血症小鼠的肌肉再生.
结论:
- 葡萄糖皮质激素治疗在严重疾病中部分逆转低胆固醇血症.
- 治疗导致上腺功能受损,肌肉再生减少,体重减轻增加.
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