肥胖患者血浆ACTH水平及对地塞米松抑制后的反应

The levels of plasma ACTH responding to dexamethasone

本文观察了22例单纯肥胖患者和18例正常体重者2400及0800时血浆ACTH水平及对小剂量地塞米松抑制后的反应,并同时测定了血清皮质醇(F)和尿游离皮质醇(UFC)。结果提示肥胖患者下丘脑——垂体——肾上腺轴反馈调节功能正常,但其2400时ACTH水平高于正常体重者(p<0.1),并与F分离,其原因有待进一步探讨。

The levels of plasma ACTH at 2400 and 0800 were determined in 22 patients with simple obesity(obese) and 18 normal weight subjects(normal). Small dose dexamethasone suppressing test(DST) was done in all obese and 10 normal. Serum cortisol(F) and urinary free cortisol(UFC) were investigated at the same time. The results showed that the level of ACTH at 2400 was the same as that at 0800 in the obese (P>0.05) , but higher than that the level at 2400 in the normal (p<0.1). In fact, the level of ACTH at 2400 in normal was much lower than that at 0800 (p<0.01). However, the F values at 2400 and 0800 were similar in both groups, also the levels of UFC were not markedly different. After DST was performed the levels of ACTH, F and UFC were all suppressed. It was suggested that there may be an increase in secretion of ACTH on obese patients with enhanced cortisol metabolism by adipose tissue, while the feed-back regulating function of hypothalamus-pituitary-adrenal axis remains normal.