晨点尿中皮质醇与肌素的比例:一种新的查工具,用于评估过多的皮质醇分泌
Yingning Liu1, Ping Zhang1, Simin Zhang1
1Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Center, Beijing, China.
Frontiers in endocrinology
|December 5, 2025
概括
一种新的早晨小便皮质醇与肌素比率 (UCCR) 提供了一种更简单的查方法来检测高皮质醇症. 这种生物标志物可靠地帮助排除过多的皮质醇分泌,尽管建议男性和糖尿病患者谨慎使用.
科学领域:
- 内分泌学 在内分泌学.
- 临床诊断 临床诊断 临床诊断
- 生物标志物发现发现
背景情况:
- 目前用于查高皮质醇症的查方法存在临床限制.
- 准确有效的诊断工具对于管理与过多的皮质醇分泌相关的疾病至关重要.
研究的目的:
- 提出和验证晨点尿皮质醇与肌素比率 (UCCR) 作为评估高皮质醇症的简单生物标志物.
- 为了评估早晨点点UCCR的诊断性能,与已建立的方法相比,如1mg一夜间德甲抑制试验 (1mg DST).
主要方法:
- 一项涉及167名住院的中国患者的横截面研究,这些患者接受了1毫克的DST.
- 从早晨的尿样中测量尿液自由皮质醇 (UFC) 和肌素.
- 计算UCCR并使用接收器操作特征 (ROC) 曲线分析评估其预测性能.
主要成果:
- 晨点UCCR与24小时UFC有显著的相关性,并预测了阳性1mg DST结果.
- ROC分析显示,早晨点点UCCR与24小时UFC在预测DST后皮质醇水平升高方面具有可比性.
- 在排除皮质醇过量时,观察到早晨点UCCR的高灵敏度和负预测值,特别是对于较高的皮质醇值.
结论:
- 晨点UCCR作为可靠和更简单的替代方案,用于初步评估皮质醇分泌.
- 该测试对于排除高皮质醇症特别有价值.
- 临床应用需要在男性和糖尿病患者中谨慎使用,因为观察到的性能下降.
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