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首页> 外文期刊>Psychosomatic Medicine: Journal of the American Psychosomatic Society >Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome.
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Urinary cortisol and cortisol metabolite excretion in chronic fatigue syndrome.

机译：慢性疲劳综合征中的尿皮质醇和皮质醇代谢产物排泄。

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OBJECTIVES: Reduced basal hypothalamic-pituitary-adrenal (HPA) axis output in chronic fatigue syndrome (CFS) has been inferred from low cortisol levels in blood, saliva, and urine in some studies. Because > 95% of cortisol is metabolized before excretion, we assessed cortisol output by assay of both cortisol metabolites and free cortisol in 24-hour urine collections and also investigated sex differences in these between CFS and control groups. METHOD: We calculated total urinary cortisol metabolites (TCM) and cortisol metabolite ratios from individual steroid data in 40 patients (20 males and 20 females) with CFS who were free of medication or comorbid psychiatric disorder likely to influence the HPA axis. Results were compared with those of 40 healthy volunteers (20 males and 20 females) well matched for age and body mass index. Data for free cortisol was obtained on 28 of the patients and 27 of the controls. RESULTS: The mean of TCM and cortisol metabolite ratios was not significantly different between patients and controls for either sex (p > .05 for all parameters). Previously established sex differences were confirmed in our controls and were found to be similar in CFS for TCM and the ratios 11OH/11OXO, 5alpha/5beta THF, and 20OH/20OXO (see text) (p < .005, p < .05, p < .05, and p < .005, respectively). Urinary free cortisol values were numerically (but not statistically) lower in patients with CFS than controls, and correlated inversely with fatigue levels in patients. CONCLUSION: The finding of normal urinary cortisol metabolite excretion in patients with CFS is at variance with earlier reports that CFS is a hypocortisolemic state. If serum and saliva cortisol levels are lower in CFS, this would suggest that metabolic clearance of cortisol is faster in patients with CFS than controls. This study also demonstrates that sex differences must be taken into account when interpreting results in patients with CFS.
机译：目的：在某些研究中，由血液，唾液和尿液中的皮质醇水平低，可以推断出慢性疲劳综合征（CFS）中下丘脑-垂体-肾上腺（HPA）轴的输出减少。由于> 95％的皮质醇在排泄前被代谢，因此我们通过分析24小时尿液收集物中的皮质醇代谢物和游离皮质醇来评估皮质醇的输出，并研究了CFS与对照组之间的性别差异。方法：我们根据40名CFS患者（无药物或可能影响HPA轴的合并性精神病）的类固醇激素数据计算了总尿皮质醇代谢物（TCM）和皮质醇代谢物比率。将结果与年龄和体重指数完全匹配的40名健康志愿者（20名男性和20名女性）的结果进行比较。获得了28位患者和27位对照中游离皮质醇的数据。结果：男女患者中医和皮质醇代谢物比率的平均值无显着差异（所有参数的p> 0.05）。在我们的对照中确认了先前确定的性别差异，并且发现中医在CFS中的性别差异与11OH / 11OXO，5alpha / 5beta THF和20OH / 20OXO的比率相似（参见文本）（p <.005，p <.05 p <.05和p <.005）。 CFS患者的尿中游离皮质醇值在数值上（而非统计学上）低于对照组，并且与患者的疲劳水平成反比。结论：CFS患者尿皮质醇代谢产物正常排泄的发现与先前报道的CFS是一种低皮质醇状态不一致。如果CFS中的血清和唾液皮质醇水平较低，则表明CFS患者的皮质醇代谢清除率快于对照组。这项研究还表明，在解释CFS患者的结果时必须考虑性别差异。

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