Anterior Pituitary Hormones in Blood and Cerebrospinal Fluid of Patients in Neurocritical Care.
Anterior pituitary hormones
cerebrospinal fluid
circadian rhythm
neurocritical care
Journal
TouchREVIEWS in endocrinology
ISSN: 2752-5457
Titre abrégé: touchREV Endocrinol
Pays: England
ID NLM: 101779126
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
06
03
2022
accepted:
16
05
2022
entrez:
11
8
2022
pubmed:
12
8
2022
medline:
12
8
2022
Statut:
ppublish
Résumé
Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels. Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay. Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH. CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.
Sections du résumé
BACKGROUND
BACKGROUND
Anterior pituitary hormones in blood follow a circadian rhythm, which may be influenced by various factors such as intracranial pathologies. In cerebrospinal fluid (CSF), pituitary hormones have been collected only selectively and circadian rhythm has not yet been investigated. This pilot study analysed diurnal variations of anterior pituitary hormones in patients in neurocritical care to determine whether circadian rhythmicity exists in these patients. Possible influences of intracranial pathologies were also investigated. Blood and CSF concentrations were assessed simultaneously to explore the value of blood concentrations as a surrogate parameter for CSF levels.
METHODS
METHODS
Blood and CSF samples of 20 non-sedated patients were collected at 06:00, noon, 18:00 and midnight, and analysed for adrenocorticotropic hormone (ACTH), cortisol, thyroid-stimulating hormone (TSH) and insulin-like growth factor-1 (IGF-1) concentrations at each of the four time points. ACTH and IGF-1 were measured by sandwich chemiluminescence immunoassay. Cortisol and TSH were measured by electrochemiluminescence immunoassay.
RESULTS
RESULTS
Results showed inconsistent circadian rhythms. Less than 50% of the patients showed a circadian rhythmicity of ACTH, cortisol, TSH or IGF-1. Significance of diurnal variations was only present for blood concentrations of TSH. Correlations between blood and CSF concentrations were strong for cortisol and TSH.
CONCLUSIONS
CONCLUSIONS
CSF concentrations were only in the measurable range in some of the patients. No clear circadian rhythmicity could be identified, except for TSH in blood. Absence of significant diurnal variations could be explained by the underlying pathologies or disturbing influences of the intensive care unit. Blood concentrations of cortisol and TSH may be suitable surrogate parameters for CSF.
Identifiants
pubmed: 35949361
doi: 10.17925/EE.2022.18.1.71
pmc: PMC9354947
doi:
Types de publication
Journal Article
Langues
eng
Pagination
71-79Informations de copyright
© Touch Medical Media 2022.
Déclaration de conflit d'intérêts
Disclosures: Henriette Beyer, Nicole Lange, Armin H Podtschaske, Jan Martin, Lucia Albers, Alexander von Werder, Jürgen Ruland, Gerhard Schneider, Bernhard Meyer, Simone M Kagerbauer and Jens Gempt have no financial or non-financial relationships or activities to declare in relation to this article.
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