在极度早产婴儿中皮质和17OH孕的升高以及临床影响
Julie M Kessel1, Patrice K Held2, Eric R Bialk3
1Dept of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. jmkessel@wisc.edu.
Pediatric research
|August 7, 2025
概括
过早出生的婴儿表现出改变的类固醇特征,高水平的17-原 (17OHP4) 和皮质表明上腺功能不充分. 这些发现有助于管理早产新生儿的上腺功能.
科学领域:
- 新生儿内分泌学 新生儿内分泌学
- 儿科内分泌学 儿科内分泌学
- 生物化学 生物化学
背景情况:
- 了解早产新生儿的妊娠年龄调整的类固醇特征,对于诊断和管理上腺功能不全至关重要.
- 目前的知识差距阻碍了早产婴儿产后类固醇治疗的最佳时间,剂量和持续时间.
- 在早产期评估胎儿上腺功能对于改善临床结果至关重要.
研究的目的:
- 通过分析早产新生儿的类固醇特征,评估早产对胎儿上腺功能的影响.
- 为了确定关键类固醇激素的妊娠年龄调整的参考范围.
- 为了为临床决策提供有关早产婴儿上腺功能缺陷的信息.
主要方法:
- 在813名新生儿中对皮质醇及其生物合成前体的量化检查,查干血斑 (DBS).
- 在出生后72小时内收集样本,大约两周后再次采集样本.
- 使用液体染色学-并联质谱法 (LC-MS/MS) 测量了类固醇水平,并按妊娠年龄和产后年龄分层.
主要成果:
- 极度早产的婴儿表现出较高的皮质醇水平,随着妊娠年龄的增加而下降.
- 在大多数早产新生儿中,17-原 (17OHP4) 和皮质的含量显著更高,而17-原与妊娠年龄相反相关.
- 妊娠年龄对阿尔多素水平没有影响.
结论:
- 增加的17OHP4和皮质,而不仅仅是皮质醇,表明早产对上腺功能不足的影响.
- 患有高皮质醇,皮质和17OHP4的早产婴儿可能有下丘脑-垂体-上腺轴功能受损,增加上腺危机的风险.
- 这些发现为解释早产婴儿的类固醇数据提供了一个框架,指导对上腺功能不充分的管理.
相关概念视频
01:31Hormones of the Adrenal Glands
2.9K
Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
2.9K
01:27Adrenal Gland Disorders
1.8K
Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
1.8K
01:07Teratogenicity
2.8K
The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
2.8K
01:24Gonadal and Placental Hormones
1.8K
The gonads, namely the testes in males and the ovaries in females, are pivotal in producing gonadal hormones that orchestrate the intricate processes of sexual development and reproduction.
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair...
In males, testosterone is the primary gonadal androgen. It plays a central role in the maturation of male reproductive organs — the penis and testes. Additionally, testosterone is instrumental in the development of secondary sexual characteristics — a deep voice as well as facial and pubic hair...
1.8K