甲状腺功能状态对ACTH和皮质醇分泌的影响

甲亢患者的ACTH-F基础分泌节律正常,由于降解加速而致F水平降低,ACTH水平反馈性升高,ACTH对氟美松抑制和胰岛素低血糖兴奋的反应正常。甲减患者的基础分泌节律正常,F增高,ACTH正常。ACTH对抑制和兴奋试验的反应性减低,表明甲减时垂体ACTH细胞功能受损。

Effect of thyroid function on the secretion of ACTH and cortisol

Patients with thyrotoxicosis were found to have a normal circadian rhythm of ACTH and F, but the level of serum F was lower than controls due to excessive degration and plasmal ACTH higher than controls by feedback regulation. The responsiveness of ACTH to dexamethasone suppression or insulin hypoglycemic stimulation was normal. Whereas the circadian secretion of ACTH and F was also normal in patients with primary hypotyroidism, the concentration of F was increased with normal ACTH level. There were stunted responses of ACTH to suppressing and stimulating tests. It was thought that the corticotrophs were insulted by hypertrophy or hyperplasia of thyrotrophs during primary hypothyroidism.