Neurology:长期皮质醇测量预测阿尔茨海默病风险

2016-12-18 haofan MedSci原创

皮质醇失调表现为高水平的UFC/Cr比值和UFC/Cr变异性,它可调节阿尔茨海默病的临床表现或是作为阿尔茨海默病的临床前标记。

近日,神经病学领域权威杂志Neurology上发表了一篇来自亚特兰大乔治亚理工学院心理系的Gilda E. Ennis博士及其研究团队的文章,旨在探讨长期的皮质醇测量是否能够预测阿尔茨海默病发生的风险。

研究人员采用前瞻性纵向研究来探讨皮质醇失调是阿尔茨海默病的风险相关。参加者来自巴尔的摩衰老纵向研究(BLSA),并且在平均间隔为10.56年的时间内提交了多个24小时尿样品。研究者测定了尿标本中游离皮质醇(UFC)和肌酐(Cr)水平,并计算UFC/Cr比值来对UFC进行标准化。测量皮质醇的调节,研究者采用了个人UFC/Cr水平(即,个人平均值)、随着时间而变化的UFC/Cr变化值(即,个人斜率)以及UFC/Cr变异性(即,个人变异系数)。研究人员采用Cox回归评估了UFC/Cr测量能否预测阿尔茨海默病的风险。

研究者发现UFC/Cr水平和UFC/Cr变异性,但不是UFC/Cr斜率,在阿尔茨海默病的发病前平均2.9年的时间里是阿尔茨海默病发生风险的显著预测因素。升高的UFC/Cr水平和UFC/Cr变异性分别导致阿尔茨海默病发生风险增加1.31和1.38倍。在敏感性分析中,增加的UFC/Cr水平和UFC/Cr变异性可以预测阿尔茨海默病发病前6年时间里是增加的阿尔茨海默病发生风险。

由此可见,皮质醇失调表现为高水平的UFC/Cr比值和UFC/Cr变异性,它可调节阿尔茨海默病的临床表现或是作为阿尔茨海默病的临床前标记。

原始出处:


Gilda E. Ennis, et al. Long-term cortisol measures predict Alzheimer disease
risk
. 2016. Neurology.  

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    2017-01-09 yinhl1978
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患者女,32岁,甲状腺功能减退症,因慢性疲劳和体重减轻9公斤就诊。 否认感染史,否认近期旅行史。 查体:BMI 20;生命体征正常;掌纹和颊粘膜色素沉着。 实验室检查如下: 你觉得患者最可能诊断为什么?接下来你需要做什么? A说:先天性肾上腺皮质增生症(CAH)吗?那我要检测血清17羟孕酮情况。 B说:是原发性肾上腺功能不全吗?我需要患者的250-μg促肾上

JCEM:库欣病患者术后评估:去氨加压素试验 vs 皮质醇水平

成功经蝶窦手术(TSS)治疗库欣病(CD)后,CD的复发率较高。很多CD患者表现出异常的去氨加压素试验(DT)。术后这种反应的消失,可能暗示异常促肾上腺皮质激素细胞的完全切除和更低的复发可能性。 本项回顾性研究,比较术后DT vs.术后皮质醇(Cort)水平,对患者长期结局的预测。 研究纳入了73名进行TSS和术后DT的患者,51例出现持续缓解(定义:6个月时,地塞米松抑制试验和UFC

Endocr Pract:夜间唾液皮质醇升高或可预测库欣病复发

目的:评估生化标志物对复发性库欣病(CD)的检测性能,以及早期干预对深夜唾液皮质醇升高(LNSC)和正常尿游离皮质醇(UFC)复发性CD对患者的潜在益处。方法:单中心、回顾性研究,纳入2008-2013年治疗的患者,复发性定义为CD术后缓解后,但LNSC、UFC、或地塞米松抑制试验(DST)结果异常。结果:该研究纳入了15例复发性CD患者,除了一例,其余患者全部检测了LNSC、DST和UFC。12