“标本配穴”电针和限食干预对肥胖大鼠HPA轴及糖脂代谢的影响

目的 研究“标本配穴”电针和饮食控制对肥胖大鼠HPA轴及糖脂代谢的影响。方法 雄性Wistar大鼠随机分为5组,正常组（N）给予普通饲料喂养,模型组（M）给予高脂喂养,电针组（E）高脂喂养的同时给予“标本配穴”电针治疗,限食组（R）每只给予对照组摄食量的70%,电针+限食组（E+R）给予“标本配穴”电针结合饮食控制干预治疗,共干预8周。检测各组大鼠体重（BW）、血清糖脂（FPG、FINS、TG、TC）和ACTH、CORT水平变化,并检测下丘脑CRH含量。结果 (1) 与N组比较,M组BW及FPG、FINS、TG和TC均明显增加（P ＜0.01）,与M组比较,3个电针和饮食干预组BW及FPG、FINS、TG和TC均明显下降（P ＜0.01）,且E+R组下降程度优于E组和R组（P ＜0.05）;(2) 与N组比较,M组下丘脑CRH及血清ACTH、CORT均明显升高（P ＜0.01）,与M组比较,3个电针和饮食干预组CRH、ACTH及CORT均明显下降（P ＜0.01）,且E组效果优于R组（P ＜0.05）,而E+R组与E组比较无统计学差异（P ＞0.05）。结论 高脂饮食诱导的肥胖模型大鼠表现出HPA轴功能亢进,拮抗HPA轴亢进可能是“标本配穴”电针和饮食控制发挥减肥、改善糖脂代谢作用的途径之一。     

自拟解郁方对抑郁症大鼠下丘脑-垂体-肾上腺轴相关激素的影响

目的探讨自拟解郁方对慢性不可预见性温和应激(chronic unpredictable mild stress,CUMS)致抑郁症大鼠下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴相关激素的影响。方法 2014年12月—2015年3月,选择40只大鼠随机分为对照组、模型组、氟西汀组、解郁方组各10只。模型组、氟西汀组、解郁方组采用CUMS构建抑郁模型,对照组及模型组给予生理盐水灌胃,氟西汀组给予氟西汀灌胃,解郁方组给予自拟解郁方灌胃,持续21 d。用药结束后,进行敞箱实验、糖水偏好实验;检测大鼠血清促肾上腺皮质激素释放激素(corticotropin releasing hormone,CRH)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)、皮质酮(corticosterone,CORT)的含量。计量资料采用方差分析,两两比较采用LSD-t检验,P0.05为差异有统计学意义。结果模型组水平穿越格数、竖立次数和糖水偏好水平分别为(44.18±2.60)个、(13.24±2.05)次、(0.549±0.019),明显降低对照组的(91.89±2.37)个、(23.46±2.13)次、(0.735±0.021),差异均有统计学意义(均P0.05)。模型组CRH、ACTH、CORT水平分别为(72.62±7.98)pg/ml、(54.34±3.97)、(36.26±6.96)ng/ml,均高于对照组的(51.15±5.67)pg/ml、(40.27±3.16)、(23.75±6.34)ng/ml,差异均有统计学意义(均P0.05)。与模型组相比,氟西汀组、解郁方组水平穿越格数、竖立次数和糖水偏好[(73.09±2.84)个、(19.26±2.14)次、(0.656±0.021)、(72.29±1.59)个、(19.19±2.17)次、(0.661±0.017)]明显增高,差异均有统计学意义(均P0.05)。氟西汀组和解郁方组CRH、ACTH、CORT水平分别为(62.37±6.17)pg/ml、(45.61±3.25)、(25.61±5.35)ng/ml、(61.89±6.03)pg/ml、(45.31±3.34)、(25.37±5.26)ng/ml,均低于模型组,差异均有统计学意义(均P0.05)。结论自拟解郁方对CUMS诱导的抑郁症大鼠HPA轴相关激素具有调节作用。     

促肾上腺皮质激素释放激素在足月产及早产中的作用

1981年,Vale从羊的下丘脑提纯出一种激素,因此激素控制着促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)的释放,调节下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴对应激的反应,故命名为促肾上腺皮质激素释放激素(corticortropin-releasing hormone,CRH)。以后的研究表明CRH不仅在脑组织中广泛分布,也可来源于外周组织及人的胎儿胎盘单位。现已证明人类胎盘中有CRH、CRH受体(CRH-receptor,CRH-R)、CRH结合蛋白(CRH-binding protein,CRHBP)及CRH信使RNA(CRHmRNA)的表达。 CRH为41个氨基酸的肽类,分子量4 670,基因定位于第8号染色体的长臂上,由2个外显子和1     

高脂饮食结合慢性应激对大鼠下丘脑-垂体-肾上腺轴及胰岛素抵抗的影响

[目的]探讨高脂饮食结合慢性应激对大鼠下丘脑-垂体-肾上腺轴(HPA轴)及胰岛素抵抗(IR)的影响.[方法]雄性Wistar大鼠32只,随机分为4组,每组8只,分别是A组,普通饲料喂养对照组;B组,高脂饲料喂养组;C组,慢性应激组(单纯足底电刺激并辅以噪声刺激);D组,高脂饲料结合慢性应激组.12周后,用高胰岛素正常血糖钳夹技术评价胰岛素敏感性,检测皮质酮、促肾上腺皮质激素(ACTH)、血糖和血清胰岛素的含量.[结果]第12周后,B组的体重与A组相比有所升高,但无统计学意义(P＞0.05).C组和D组的体重与A组相比明显降低(P＜0.05);与A组相比,B、C、D组的ACTH和皮质酮明显升高(P＜0.05).同时与B、C两组比较,D组的ACTH和皮质酮也明显升高(P＜0.05);与A组相比,B、C组的血糖值无统计学意义(P＞0.05),而D组血糖与A组相比,有统计学意义(P＜0.05),同时与B、C两组比较,D组的血糖也明显升高(P＜0.05).B、D组的胰岛素含量与A组相比均明显升高(P＜0.05).与A组相比,B、C、D组的葡萄糖输注率(GIR)均明显下降(P＜0.05),其中D组GIR下降了78.7%.D组的GIR与B、C组相比也明显降低(P＜0.05).[结论]高脂饮食、慢性应激均能增强大鼠HPA轴的活性及导致IR;同时,两者相结合对增强大鼠HPA轴的活性及导致IR具有协同作用.     

应激对大鼠摄食量的影响及其机制的探讨

目的 观察应激因素作用下大鼠摄食量的变化，并初步探讨可能涉及的作用机制。方法 将Wistar大鼠按体重随机分为对照组、1周应激组、2周应激组、3周应激组。记录各组大鼠摄食量的变化，观察下丘脑—垂体—肾上腺轴(HPA轴)中各激素水平的改变，测定脑组织中促肾上腺皮质激素释放激素(CRH)和脑肠肽类递质神经降压素(neurotensin，NT)的含量，以及血浆中NT、胃泌素、乙酰胆碱酯酶(acetylcholinesterase)的水平。结果 各应激组摄食量明显降低。以2、3周应激组最为明显；各应激组HPA轴均处于激活状态。3周时趋向适应；NT、含量在脑和血浆中都呈现一个早期升高晚期回落的过程；应激状态使血浆胃泌索明显上升，而乙酰胆碱酯酶水平明显下降。结论 应激可导致大鼠摄食量减少，其机制可能涉及HPA轴和迷走神经的激活，以及NT和胃泌素等脑肠肽在中枢和外周的调控。     

恐惧应激大鼠血ACTH、CORT、IL-2、IL-8的含量变化

目的探索"恐惧"情绪应激对大鼠内分泌及免疫系统的影响。方法根据Takashi方法建立恐惧应激模型,通过放射免疫方法检测ACTH、CORT、IL-2和IL-8,并与正常组、孤独饲养组进行对照。结果各组大鼠ACTH、CORT均有显著差异(F值分别10.466、13.804;均为P<0.01)。恐惧模型组ACTH、CORT水平高于正常对照组及孤独饲养组。各组大鼠IL-8比较,存在显著差异(F=3.489,P=0.049),恐惧模型组血清IL-8水平高于正常对照组,各组大鼠IL-2未见显著差异(F=1.355,P=0.280)。结论恐惧可通过激活HPA轴,升高ACTH、CORT水平这一途径调控应激反应。恐惧应激可提高IL-8水平,对机体免疫功能有抑制作用。     

联合抗阻-有氧运动对乳腺癌化疗后癌因性疲乏患者下丘脑-垂体-肾上腺皮质轴功能的影响

目的探讨联合抗阻-有氧运动对乳腺癌化疗后癌因性疲乏(CRF)患者下丘脑-垂体-肾上腺皮质轴功能的影响。方法选取2018年6月-2020年9月来该院就诊的90例乳腺癌化疗后CRF患者为研究对象,随机分为观察组与对照组,各45例。对照组予以有氧运动治疗,观察组在对照组基础上加抗阻运动,两组均治疗12周。观察两组患者治疗前后CRF症状、下丘脑-垂体-肾上腺皮质轴(TPA)功能指标变化并比较临床疗效。结果治疗后,两组行为疲乏、情感疲乏、躯体疲乏及认知疲乏评分较治疗前均明显下降(均P0.05),治疗后观察组行为疲乏、情感疲乏、躯体疲乏及认知疲乏评分分别为(4.06±0.51)分、(4.18±0.63)分、(4.28±0.66)分及(4.12±0.61)分,均低于对照组的(4.78±0.61)分、(4.91±0.76)分、(5.06±0.72)分及(4.72±0.69)分,差异均有统计学意义(t=2.219、2.254、2.302及2.191,均P0.05);两组血清促肾上腺皮质激素(ACTH)水平较治疗前明显下降,血清皮质醇(CORT)水平较治疗前明显上升(均P0.05),且治疗后观察组血清ACTH水平低于对照组,血清CORT水平高于对照组(P0.05);治疗后观察组临床总有效率(95.56%)明显高于对照组(82.22%),差异有统计学意义(χ~2=4.05,P0.05)。结论联合抗阻-有氧运动治疗乳腺癌化疗后CRF患者的疗效确切,可明显减轻CRF症状,其作用机制可能与其能抑制血清ACTH分泌,促进血清CORT的分泌,从而调节TPA轴功能紊乱密切相关。     

噪声应激对大鼠淋巴细胞增殖功能和ACTH的影响

目的观察噪声应激对大鼠淋巴细胞增殖功能和血浆促肾上腺皮质激素(ACTH)的影响。方法将大鼠暴露于白噪声发生器输出放大的(100±1.5)dB(A)噪声中,检测不同噪声暴露时间(1、7、21d)大鼠淋巴细胞增殖功能和血浆中ACTH的变化。结果在接噪期间淋巴细胞增殖功能降低;血浆ACTH水平暴露1d后显著升高,连续暴露21d后显著降低。结论短期、长期噪声暴露均可抑制细胞免疫功能,其抑制机制可能与下丘脑-垂体-肾上腺(HPA)轴有关。     

短期海上航行者血浆促肾上腺皮质激素含量变化及与晕船关系

海上航行中的生活与工作环境和陆地有很大差别,对人员是一种应激。航海环境的应激因素很多,如噪声、空间限制、摇晃等,舰船人员,特别是初次、短期出航者,主要不适是海上颠簸引起的晕船症状,主要表现为眩晕及恶心呕吐等胃肠道症状。促肾上腺皮质激素(ACTH)是“下丘脑一垂体-肾上腺皮质轴”(HPA)中主要的应激激素,其水平反映整个机体的应激状态[1]。本文初步探讨了人员在航海应激环境下,机体ACTH水平的变化及与晕船症状的可能关系。     

孕期摄食限制对雌性子代老年大鼠代谢综合征易感的影响

目的探讨孕期摄食限制(prenatal food restriction,PFR)的雌性子代老年大鼠在经历体重追赶性生长和后期慢性应激后的代谢综合征(metabolic syndrome,Met S)易感现象及其可能的发生机制。方法将受孕的SPF级Wistar大鼠随机分为对照组和PFR组,每组18只。自孕11 d起至分娩,PFR组限制摄食(为对照组每日食物的50%),对照组自由饮食至自然分娩。分娩后每组筛选出窝仔数为10~12只的母鼠9窝,每窝随机抽取1只雌性仔鼠。仔鼠断乳后均给予高脂饮食至成年,出生后38周龄给予两周的预知性慢性应激,并采集应激前后仔鼠血清。以放射免疫法检测血清促肾上腺皮质激素(adreno-cortico-tropic-hormone,ACTH)和胰岛素水平,酶联免疫吸附法检测血清皮质酮(corticosterone,CORT)浓度,酶比色法检测血糖、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白-胆固醇(high-density lipoprotein,HDL-C)和低密度脂蛋白-胆固醇(low-density lipoprotein,LDL-C)浓度。结果与对照组相比,PFR组子代大鼠出生后体重偏低,但其出生后16~36周体重增长率升高。应激前,PFR组血清胰岛素、HDL-C水平降低,TC/HDL-C比值升高;应激后,PFR组血清ACTH无明显改变,CORT水平升高,血清胰岛素水平降低,血清TG水平和TG/HDL-C比值升高,差异均有统计学意义(P0.05或P0.01)。结论出生后早期经历追赶性生长的PFR雌鼠存在糖脂代谢紊乱及Met S易感,其发生可能与下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal axis,HPA)轴相关的神经内分泌代谢编程紊乱有关。     

Increased lead biomarker levels are associated with changes in hormonal response to stress in occupationally exposed male participants

Background: Lead (Pb) exposure has been associated with a host of pathological conditions in humans. In rodents Pb exposure has been shown to alter the hypothalamic–pituitary–adrenal (HPA) axis function.Objective: We investigated the effects of lead on responses of the HPA axis to a psychosocial laboratory stressor administered to Pb-exposed workers.Methods: Seventy male participants completed the Trier Social Stress Test (TSST). Serum cortisol (CORT) and plasma adrenocorticotropic hormone (ACTH) were assessed in response to and during recovery from the stressor. We measured Pb in blood, a biomarker of recent exposure, and in tibia bone by X-ray fluorescence (XRF), a biomarker of chronic exposure.Results: The TSST induced statistically significant increases in ACTH and CORT in the participants. At baseline, ACTH was not significantly higher (p = 0.052) in participants with higher blood Pb concentration, but CORT was significantly lower in these participants (p = 0.016). Adjusted linear regression models indicated a positive association between blood and bone Pb and the increase in ACTH in response to stress. However, Pb was not strongly associated with changes in CORT in response to stress. Pb was also associated with the ACTH:CORT ratio at baseline and throughout the course of the protocol, suggesting an adrenal hyporesponsiveness in participants with higher Pb concentrations.Conclusion: The altered HPA-axis stress response observed in participants exposed to higher levels of Pb further supports the idea that lead may contribute to a host of biological dysfunctions beyond the classical neurotoxic effects.     

Modified dexamethasone suppression-corticotropin-releasing hormone stimulation test: A pilot study of young healthy volunteers and implications for alcoholism research in adolescents and young adults

The key neuroendocrine component of a response to stress is the hypothalamic-pituitary-adrenocortical (HPA) system. Abnormalities in the HPA system have been implicated in the pathophysiology of psychiatric disorders such as depression, post-traumatic stress disorder, alcoholism and suicide. The dexamethasone suppression test (DST) is the most frequently used test to assess HPA-system function in psychiatric disorders. This neuroendocrine test consists of the administration of a low dose of dexamethasone at 11 pm and the measurement of cortisol levels at one or more time points on the following day. After corticotropin-releasing hormone (CRH) became available for clinical studies, the DST was combined with CRH administration. In this test, patients are pretreated with a single dose of dexamethasone at 11 pm and receive human CRH intravenously at 3 pm the following day. The resulting DST-CRH test proved to be much more sensitive in detecting HPA system alterations than the DST. We have modified the DST-CRH test and used ovine CRH instead of human CRH in a pilot study of a group of young healthy volunteers. Results indicated that it produces results similar to the results obtained with human CRH. This suggests that ovine CRH can be used in psychiatric research. Alcoholism is associated with abnormalities in HPA function. Nonalcoholic subjects with a family history of alcoholism exhibit lower plasma ACTH and beta-endorphin as well as lower ACTH, cortisol, and beta-endorphin responses to psychological stress and CRH stimulation. This suggests that in children of alcoholics, alterations in the mechanisms that regulate HPA axis activity predate the development of alcohol dependence and may be considered inherited traits. Therefore, studies of the HPA system in persons at risk for alcoholism may help understand the neurobiological mechanisms of predisposition to alcoholism.     

孕期尼古丁暴露所致成年子代雌鼠代谢综合征易感的宫内起源机制

目的探讨孕期尼古丁暴露引起成年子代大鼠代谢综合征易感的宫内起源机制。方法Wistar孕鼠分孕期尼古丁暴露(PNE)组和对照组,分别于孕11天起给予尼古丁2mg/(kg·d)或等体积蒸馏水皮下注射至分娩,PW4后断奶留取雌性子代给予高脂饮食喂养,至PW24转回标准饮食,并于PW38-40给予2周慢性应激,末次应激后3天麻醉处死大鼠,留取血和海马组织,行相关指标检测。结果与对照组相比,PNE组PW1体重明显降低,并持续低水平至PW40,但其增长率在PW4-16明显增高;PNE组雌鼠海马组织1型11β-羟类固醇脱氢酶(11β-HSD1)表达增加,而糖皮质激素受体(GR)和盐皮质激素受体(MR)表达无明显变化;血ACTH水平无差异但血CORT水平明显升高。PNE组血糖水平、胰岛素水平及胰岛素抵抗指数(IRI)明显高于对照组,血甘油三酯(TG)、总胆固醇(TCH)和高密度脂蛋白-胆固醇(HDL-C)水平呈升高趋势,血低密度脂蛋白-胆固醇(LDL-C)水平明显高于对照组,LDL-C/HDL-C比值明显升高。结论经历生后"高营养"呈体重追赶式生长和后期慢性应激的PNE子代成年雌鼠HPA轴功能亢进,糖脂代谢紊乱,呈高血糖、高胰岛素血症,出现胰岛素抵抗,血脂紊乱,血脂比值明显升高,提示代谢综合征易感,与HPA轴相关的相关神经内分泌代谢编程紊乱有关。     

Bulimia nervosa--a primary defect in the hypothalamic-pituitary-adrenal axis?

Bulimia nervosa has been associated with impaired satiety, decreased resting metabolic rate and abnormal neuroendocrine regulation. The aim of this study was to investigate the diurnal cortisol secretion and the pituitary-adrenal response to corticotropin-releasing hormone (CRH) in subjects suffering from bulimia nervosa. Eight female subjects with remitted bulimia nervosa, ages 24-56, and 8 sex- and weight-matched controls volunteered to participate. After an overnight fast they were admitted to the Clinical Research Center for 24 hour recording of plasma cortisol secretion. Blood were drawn every 2nd hour from 8 AM. After another overnight fast, the subjects performed a 120-min CRH test (100 microg i.v.), drawn for measurements of adrenocorticotropin releasing hormone (ACTH) and cortisol. Compared to the control group (CG), the diurnal cortisol secretions in the bulimic group (BG) decreased at time points 6 AM to 2 PM. In the CRH test, the ACTH response was significantly stronger in the BG than in the CG. Similar observations were found for cortisol, although not at significant levels. Remitted bulimic patients exhibit a neuroendocrine pattern of decreased HPA axis activity with a hyperreactivity to CRH. This may indicate a complex and so far poorly understood neuroendocrine dysregulation of HPA axis associated with the disease.     

Prolonged Stimulation of Corticosterone Secretion by Corticotropin-Releasing Hormone in Rats Exhibiting High Preference for Dietary Fat

Through the secretion of corticosterone, the hypothalamo-pituitary-adrenal (HPA) axis is thought to play an important role in the regulation of caloric intake and dietary fat preference. In an earlier study, we demonstrated a positive correlation between urinary corticosterone output and dietary fat preference. Furthermore, dietary fat preference was augmented following chronic but not acute hypercorticosteronemia produced by exogenous corticosterone administration. These observations led us to explore whether the HPA axis of rats exhibiting high preference for fat may have exaggerated sensitivity to corticotropinreleasing hormone (CRH). The results of these studies show a delayed and blunted but more prolonged corticosterone response to CRH in the fat-preferring rats compared with that of the carbohydrate-preferring rats.     

Restraint stress and exogenous corticosterone differentially alter sensitivity to the sedative-hypnotic effects of ethanol in inbred long-sleep and inbred short-sleep mice

Decreased sensitivity to ethanol is a genetically mediated trait implicated in susceptibility to developing alcoholism. Here, we explore genotype by environment differences in ethanol sensitivity. The relationship between acute- and repeated-restraint stress, corticosterone (CORT) levels, and sensitivity to sedative-hypnotic properties of ethanol was explored using inbred long-sleep (ILS) and inbred short-sleep (ISS) mice. In ILS mice, acute restraint decreased ethanol sensitivity at a 4.1g/kg dose, as measured by a decrease in the duration of loss of the righting reflex (LORE) and an increase in blood ethanol concentration at regain of the righting response (BECRR). Repeated restraint also decreased LORE duration, but had no effect on BECRR. In the ISS mice, there was no effect of acute restraint on either LORE duration or BECRR. However, repeated restraint increased ethanol sensitivity at a 4.1g/kg dose; with an increase in LORE duration, but a decrease in BECRR. Differences in hypothalamic-pituitary-adrenal (HPA) axis responsiveness to restraint stress (as measured by plasma CORT) were also examined between genotypes. ILS mice displayed habituation to repeated restraint, whereas ISS mice did not. Lastly, the effect of enhanced CORT levels independent of psychological stress was examined for its effects on the sedative-hypnotic effects of ethanol. There were no effects of CORT pretreatment on LORE duration or BECRR in ILS mice compared to saline- or noninjected littermates. In contrast, ISS mice injected with CORT showed a decreased duration of LORE, but no effects on BECRR. These findings suggest that in addition to genetic susceptibility, environmental factors (e.g., restraint stress, exogenous CORT administration) also influence sensitivity to the sedative effects of ethanol through alteration of central nervous system sensitivity and pharmacokinetic parameters, and do so in a genotype-dependent manner.     

中西医治疗抑郁症疗效及对HPA轴、血清细胞因子影响研究

目的探讨逍遥散加味方联合舍曲林治疗抑郁症的疗效,并探讨其神经免疫内分泌学机制。方法采用酶联免疫吸附法检测中药逍遥散加味方合并舍曲林组、逍遥散加味方组、舍曲林组共三组(每组30例)抑郁症患者治疗前后及正常对照组的血清IL-6、IL-1β、TNF-α的水平并比较;每组在治疗前后分别做地塞米松抑制试验(DST)并检测血浆皮质醇(CORT)和促肾上腺皮质激素(ACTH)的浓度;结合汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)进行相关分析。结果三组病例组治疗前血清IL-6、IL-1β、TNF-α、CORT、ACTH水平显著高于正常对照组(P<0.05)。三组血清IL-6、IL-1β、TNF-α、CORT、ACTH水平在治疗前后差异均有统计学意义(P<0.05)。逍遥散治疗抑郁症愈显率高,且不良反应小;中西药结合组HAMD评分治疗结束时下降更明显,与其他两组评分比较有显著性差异(P<0.05)。结论血清IL-6、IL-1β、TNF-α、CORT、ACTH水平升高可能是抑郁症的神经免疫内分泌学机制;逍遥散和舍曲林抗抑郁机制类同,均能降低IL-6、IL-1β、TNF-α水平,从而纠正HPA轴的亢进而达到抗抑郁作用。逍遥散对抑郁症疗效与舍曲林相当,两者结合疗效更佳。     

Glucocorticoid hypofunction in myotonic dystrophy

INTRODUCTION: Myotonic dystrophy (DM1) is an autosomal dominant disorder whose genetic defect consists of the amplification of an unstable CTG trinucleotide repeat in the 3' untranslated region of the dystrophia myotonica protein kinase gene (DMPK). This is a multi-systemic disease with a well-known endocrinological repercussion. With respect to the adrenal function variable results have been described, although lately they are interpreted as indicators of a hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis. MATERIAL AND METHODS: Twenty-five patients (13 men and 12 women) with DM1 were recruited. They were analysed for: basal cortisol and ACTH, stimulus test with 0.25 mg of ACTH for cortisol and CRH test for cortisol and ACTH. Similarly, the degree of expansion of CTG was evaluated by Southern blot and PCR. Twenty-five healthy individuals, comparable by age and sex, were studied as a control group; the CRH test was carried out on 11 of them. RESULT: One patient was diagnosed with primary non-autoimmune adrenal failure. In the rest of the cases there were no differences between the basal ACTH of patients and controls, and the cortisol response to ACTH was normal. The patients showed a lower level of basal cortisol (p<0.01) and also showed, following stimulation with CRH, a lower cortisol response (p<0.05) with higher average values of ACTH. CONCLUSIONS: Our data differs from the latest publications and point to an adrenal hypofunction due to lack of efficacy of the ACTH on its receptor or at the post-receptor level. We suggest that the etiology might be related to the underlying defect in the gene that codifies DMPK.     

The activity of the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system in relation to waist/hip circumference ratio in men

OBJECTIVE: To investigate possible differences, between generally and abdominally obese men, in activity and regulation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. RESEARCH METHODS AND PROCEDURES: Fifty non-diabetic, middle-aged men were selected to obtain two groups with similar body mass index (BMI) but different waist/hip circumference ratio (WHR). Measurements were performed of the activity of the HPA axis and the sympathetic nervous system, as well as metabolic and endocrine variables. RESULTS: Men with a high WHR, in comparisons with men with a low WHR, had higher insulin, glucose, and triglyceride values in the basal state and higher glucose and insulin after an oral glucose tolerance test. Men with high WHR had elevated diurnal adrenocorticotropic hormone (ACTH) values but similar cortisol values, except lower cortisol values in the morning. Diurnal growth hormone concentrations showed reduced peak size. Stimulation of the HPA axis with corticotropin-releasing hormone (CRH) and laboratory stress showed no difference in ACTH values between groups, but cortisol values were lower in men with high WHR. In comparison with men with a low WHR, men with a high WHR had elevated pulse pressure and heart rate in the basal state and after challenges by CRH and laboratory stress. They also had increased urinary excretion of catecholamine metabolites. DISCUSSION: These results suggest a mild dysregulation of the HPA axis, occurring with elevated WHR independent of the BMI. The results also indicate a central activation of the sympathetic nervous system, such as in the early phases of hypertension, correlating with insulin resistance.     

糖尿病并发抑郁症大鼠肠道菌群失衡初步研究

目的 通过对糖尿病并发抑郁症(diabetes-related depression, DD)大鼠肠道微生物进行16s rRNA测序分析，探讨该疾病状态下肠道菌群的改变。方法 建立DD模型，以健康SD大鼠作为空白对照组。每周称量体重的同时进行空腹血糖检测；采用强迫游泳和矿场实验检测大鼠行为学；对各组大鼠肠道内容物进行16s rRNA测序；以血清为检测对象，对下丘脑-垂体-肾上腺轴(hypothalamic-pituitary-adrenal axis, HPA轴)相关蛋白及细菌脂多糖(lipopolysaccharide, LPS)含量进行检测。结果 与空白组比较，DD模型组血糖显著升高并表现出明显抑郁样行为和HPA轴亢进；16s rRNA测序结果提示，与空白组比较，DD模型组肠道菌群α多样性(Chao、Simpson、Shannon指数)无明显差异；但β多样性差异明显，即空白组与DD模型组的样品间距离较远；肠道菌群组间差异明显，与空白组比较，DD模型组中厚壁菌门丰度明显降低(P<0.01),而拟杆菌门则无明显差异；Bugbase表型预测提示，与空白组比较，DD模型组中革兰氏阴性...