https://scholars.lib.ntu.edu.tw/handle/123456789/496856
標題: | Impaired hypothalamus-pituitary-adrenal axis in men with spinal cord injuries | 作者: | TIEN-SHANG HUANG Wang Y.-H. Lee S.-H. JIN-SHIN LAI |
關鍵字: | Adrenal atrophy; Hypothalamus-pituitary-adrenal axis; Neurotransmitter; Spinal cord injury | 公開日期: | 1998 | 出版社: | Williams & Wilkins Co, Baltimore | 卷: | 77 | 期: | 2 | 起(迄)頁: | 108-112 | 來源出版物: | American Journal of Physical Medicine and Rehabilitation | 摘要: | Twenty-five men with spinal cord injuries were studied for evaluation of the hypothalamus-pituitary-adrenal axis, using corticotropin-releasing hormone and insulin-induced hypoglycemia. Twenty-five age-matched healthy male volunteers served as controls. Three spinal cord-injured subjects had hyperprolactinemia, three had elevated basal follicle-stimulating hormone levels, one had an elevated basal luteinizing hormone level, and four had hypotestosteronemia. The mean plasma adrenocorticotropin response to corticotropin-releasing hormone of spinal cord-injured subjects was smaller than that of the healthy controls but did not reach a statistical significance. The cortisol response to corticotropin-releasing hormone of the spinal cord-injured subjects was significantly lower than that of healthy controls. However, the difference disappeared if a correction was made for baseline values. Six spinal cord-injured subjects did not have a cortisol response to insulin-induced hypoglycemia, and they had either a minimal or no adrenocorticotropin response. Another 11 spinal cord-injured subjects had a maximal cortisol response to insulin-induced hypoglycemia below the lowest limit of normal, i.e., 0.5 μmol/l. Among these spinal cord-injured subjects, three had a less than 50% increase of plasma adrenocorticotropin after insulin-induced hypoglycemia. These findings are consistent with the notion that spinal cord-injured subjects have an altered central neurotransmitter tone and substantiate the hypothesis that an afferent neural pathway exists between the adrenal and hypothalamus and may modulate stress-induced secretion of adrenocorticotropin. Long-term abnormal adrenocorticotropin secretion may cause mild adrenocortical atrophy and, thereby, a reduced cortisol response.Twenty-five men with spinal cord injuries were studied for evaluation of the hypothalamus-pituitary-adrenal axis, using corticotropin-releasing hormone and insulin-induced hypoglycemia. Twenty-five age-matched healthy male volunteers served as controls. Three spinal cord-injured subjects had hyperprolactinemia, three had elevated basal follicle-stimulating hormone levels, one had an elevated basal luteinizing hormone level, and four had hypotestosteronemia. The mean plasma adrenocorticotropin response to corticotropin-releasing hormone of spinal cord-injured subjects was smaller than that of the healthy controls but did not reach a statistical significance. The cortisol response to corticotropin-releasing hormone of the spinal cord-injured subjects was significantly lower than that of healthy controls. However, the difference disappeared if a correction was made for baseline values. Six spinal cord-injured subjects did not have a cortisol response to insulin-induced hypoglycemia, and they had either a minimal or no adrenocorticotropin response. Another 11 spinal cord-injured subjects had a maximal cortisol response to insulin-induced hypoglycemia below the lowest limit of normal, i.e., 0.5 μmol/l. Among these spinal cord-injured subjects, three had a less than 50% increase of plasma adrenocorticotropin after insulin-induced hypoglycemia. These findings are consistent with the notion that spinal cord-injured subjects have an altered central neurotransmitter tone and substantiate the hypothesis that an afferent neural pathway exists between the adrenal and hypothalamus and may modulate stress-induced secretion of adrenocorticotropin. Long-term abnormal adrenocorticotropin secretion may cause mild adrenocortical atrophy and, thereby, a reduced cortisol response. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0032031679&doi=10.1097%2f00002060-199803000-00004&partnerID=40&md5=4a19e6813c47be8858a4b31e3a835dbb https://scholars.lib.ntu.edu.tw/handle/123456789/496856 |
ISSN: | 0894-9115 | DOI: | 10.1097/00002060-199803000-00004 | SDG/關鍵字: | Insulin; Neurophysiology; Hypothalamus pituitary adrenal axis; Neurotransmitters; Spinal cord injuries; Patient rehabilitation; corticotropin; corticotropin releasing factor; follitropin; hydrocortisone; insulin; luteinizing hormone; neurotransmitter; prolactin; testosterone; adrenal cortex insufficiency; adult; article; clinical article; controlled study; corticotropin release; follitropin blood level; hormone response; human; hydrocortisone release; hyperprolactinemia; hypothalamus hypophysis adrenal system; luteinizing hormone blood level; male; spinal cord injury; testosterone blood level |
顯示於: | 醫學系 |
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