Changes and Clinical Value of Serum Cortisol Levels in Patients with Hypertensive Disorder in Pregnancy

Objective:To investigate the changes and the corresponding clinical value of serum cortisol levels in patients with hypertensive disorders during pregnancy.Methods:In this study,90 patients with different degrees of hypertensive disorders during pregnancy who were admitted from August 2018 to August 2019 in our hospital were set as the research objects.90 cases were grouped according to the diagnostic criteria in Obstetrics and Gynecology,including 30 cases in each of the hypertension group,the preeclampsia group,and the eclampsia group.Another 30 healthy pregnant women were selected as the control group.The serum cortisol levels of pregnant women in the above four groups were measured.Results:Compared with the control group,the serum cortisol levels in the other three groups were significantly increased.In perinatal outcome,compared with the control group,the three groups of patients had an increase in Apgar score,preterm birth,stillbirth rate,growth restriction rate and neonatal asphyxia rate.There were significant differences between groups(P<0.05),and showed as gestational hypertension<preeclampsia<eclampsia.Conclusion:With the exacerbation of hypertensive disorders during pregnancy,the serum cortisol level continues to increase,which has a serious adverse effect on the prognosis of the perinatal infants.

Effects of Serum Cortisol Levels on Perinatal Prognosis in Patients with Hypertensive Disorder

Objective:To investigate the effect of serum cortisol level on perinatal prognosis in patients with hypertensive disorder during pregnancy.Methods:In this study,different degrees of patients with hypertensive disorder during pregnancy who were admitted from August 2018 to August 2019 in our hospital were selected as the research subjects,and divided into groups according to the severity of the patients’conditions.The 120 patients were divided into gestational hypertension group,preeclampsia group and eclampsia group,with 40 cases each,and another 40 healthy pregnant women were selected.The detection of serum cortisol levels was carried out for the above 4 groups of pregnant women.Results:The serum cortisol level in the control group was(260.35±10.96)nmol/L.The case number of neonatal asphyxia was 1(2.50%),the case number of premature births was 1(2.50%),the number of fetal growth restriction was 1(2.50%),the number of deaths was 0,and the other three groups were higher than this.It showed as gestational hypertension<preeclampsia<eclampsia.The Apgar score of pregnant women in the control group was(9.13±0.29),the ZL index was(1.07±0.07),and the other three groups were lower than this.It showed as gestational hypertension>preeclampsia>eclampsia.There were significant differences between groups(all P<0.05).Conclusion:Early detection of serum cortisol levels in pregnant women is beneficial to timely improve the symptoms of gestational hypertension,thereby suppressing the effects of serum cortisol on perinatal infants and improving the prognosis of newborns.

Evaluation of Basal Serum Adrenocorticotropic Hormone and Cortisol Levels and Their Relationship with Nonalcoholic Fatty Liver Disease in Male Patients with Idiopathic Hypogonadotropic Hypogonadism

Background： Prolonged gonadal hormone deficiency in patients with idiopathic hypogonadotropic hypogonadism （IHH） may produce adverse effects on the endocrine homeostasis and metabolism. This study aimed to compare basal serum adrenocorticotropic hormone （ACTH） and cortisol levels between male IHH patients and healthy controls. Moreover, this study compared the basal hypothalamic-pituitary-adrenal （HPA） axis in patients with and without nonalcoholic fatty liver disease （NAFLD）, and also evaluated the relationship between basal HPA axis and NAFLD in male IHH patients. Methods： This was a retrospective case-control study involving 75 Chinese male IHH patients （mean age 21.4 ± 3.8 years, range 17 30 years） and 135 healthy controls after matching tbr gender and age. All subjects underwent physical examination and blood testing for serum testosterone, luteinizing hormone, follicle-stimulating hormone. ACTH, and cortisol and biochemical tests. Results： Higher basal serum ACTH levels （8.25 ±3.78 pmol/L vs. 6.97 ±2.81 pmol/L） and lower cortisol levels （366.70 ±142.48 nmol/L vs. 452.82 ± 141.53 nmol/L） were observed ill male IHH patients than healthy subjects （all P 〈 0.05）. IHH patients also showed higher metabolism parameters and higher prevalence rate of NAFLD （34.9% vs. 4.4%） than the controls （all P 〈 0.05）. Basal serum ACTH （9.91 ±4.98 pmol/L vs. 7.60 ±2.96 pmol/L） and dehydroepiandrosterone sulfate （2123.7 ±925.8 μg/L vs. 1417.1 ±498.4 μg/L） levels were significantly higher in IHH patients with NAFLD than those without NAFLD （all P 〈 0.05）. We also found that basal serum ACTH levels were positively correlated with NAFLD （r = 0.289, P 〈 0.05） and triglyceride levels （r - 0.268, P 〈 0.05） in male IHH patients. Furthermore, NAFLD was independently associated with ACTH levels in male IHH patients by multiple linear regression analysis. Conclusions： The male IHH patients showed higher basal serum ACTH levels and lower cortisol levels than matched healthy controls. NAFLD was an independent associated factor for ACTH levels in male IHH patients. These preliminary findings provided evidence of the relationship between basal serum ACTH and NAFLD in male IHH patients.

Effects of Short-Term Forest Bathing on Human Health in a Broad-Leaved Evergreen Forest in Zhejiang Province,China

Objective To investigate the effects of short-term forest bathing on human health. Methods Twenty healthy male university students participated as subjects and were randomly divided into two groups of 10. One group was sent on a two-night trip to a broad-leaved evergreen forest, and the other was sent to a city area. Serum cytokine levels reflecting inflammatory and stress response, indicators reflecting oxidative stress, the distribution of leukocyte subsets, and plasma endothelin-1 （ET-1） concentrations were measured before and after the experiment to evaluate the positive health effects of forest environments. A profile of mood states （POMS） evaluation was used to assess changes in mood states. Results No significant differences in the baseline values of the indicators were observed between the two groups before the experiment. Subjects exposed to the forest environment showed reduced oxidative stress and pro-inflammatory level, as evidenced by decreased malondialdehyde, interleukin-6, and tumor necrosis factor a levels compared with the urban group. Serum cortisol levels were also lower than in the urban group. Notably, the concentration of plasma ET-1 was much lower in subjects exposed to the forest environment. The POMS evaluation showed that after exposure to the forest environment, subjects had lower scores in the negative subscales, and the score for vigor was increased. Conclusion Forest bathing is beneficial to human health, perhaps through preventive effects related to several pathological factors.