Alterations in Hypothalamus-Pituitary-Adrenal/Thyroid Axes and Gonadotropin-Releasing Hormone in the Patients with Primary Insomnia: A Clinical Research

The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This study included 30 patients with primary insomnia (PI), 30 patients with depression-comorbid insomnia (DCI), and 30 healthy controls for expl...

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Published inPloS one Vol. 8; no. 8; p. e71065
Main Authors Xia, Lan, Chen, Gui-Hai, Li, Zhi-Hua, Jiang, Song, Shen, Jianhua
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 09.08.2013
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Abstract The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This study included 30 patients with primary insomnia (PI), 30 patients with depression-comorbid insomnia (DCI), and 30 healthy controls for exploring the alterations in the hypothalamus-pituitary-adrenal/thyroid axes' hormones and gonadotropin-releasing hormone (GnRH). The Pittsburgh Sleep Quality Index was used to evaluate sleep quality in all subjects. The serum concentrations of corticotrophin-releasing hormone (CRH), thyrotrophin-releasing hormone (TRH), GnRH, adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), cortisol, total triiodothyronine (TT3), and total thyroxine (TT4) in the morning (between 0730 h and 0800 h) were detected. Compared to the controls, all hormonal levels were elevated in the insomniacs, except ACTH and TSH in the PI group. Compared to the DCI patients, the PI patients had higher levels of CRH, cortisol, TT3, and TT4 but lower levels of TRH, GnRH, and ACTH. Spearman's correlation analysis indicated that CRH, TRH, GnRH, TSH, cortisol, TT4, and TT3 were positively correlated with the severity of insomnia. The linear regression analysis showed that only CRH, GnRH, cortisol, and TT3 were affected by the PSQI scores among all subjects, and only CRH was included in the regression model by the "stepwise" method in the insomnia patients. Our results indicated that PI patients may have over-activity of the hypothalamus-pituitary-adrenal/thyroid axes and an elevated level of GnRH in the morning.
AbstractList The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This study included 30 patients with primary insomnia (PI), 30 patients with depression-comorbid insomnia (DCI), and 30 healthy controls for exploring the alterations in the hypothalamus-pituitary-adrenal/thyroid axes’ hormones and gonadotropin-releasing hormone (GnRH). The Pittsburgh Sleep Quality Index was used to evaluate sleep quality in all subjects. The serum concentrations of corticotrophin-releasing hormone (CRH), thyrotrophin-releasing hormone (TRH), GnRH, adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), cortisol, total triiodothyronine (TT3), and total thyroxine (TT4) in the morning (between 0730 h and 0800 h) were detected. Compared to the controls, all hormonal levels were elevated in the insomniacs, except ACTH and TSH in the PI group. Compared to the DCI patients, the PI patients had higher levels of CRH, cortisol, TT3, and TT4 but lower levels of TRH, GnRH, and ACTH. Spearman’s correlation analysis indicated that CRH, TRH, GnRH, TSH, cortisol, TT4, and TT3 were positively correlated with the severity of insomnia. The linear regression analysis showed that only CRH, GnRH, cortisol, and TT3 were affected by the PSQI scores among all subjects, and only CRH was included in the regression model by the “stepwise” method in the insomnia patients. Our results indicated that PI patients may have over-activity of the hypothalamus-pituitary-adrenal/thyroid axes and an elevated level of GnRH in the morning.
The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This study included 30 patients with primary insomnia (PI), 30 patients with depression-comorbid insomnia (DCI), and 30 healthy controls for exploring the alterations in the hypothalamus-pituitary-adrenal/thyroid axes' hormones and gonadotropin-releasing hormone (GnRH). The Pittsburgh Sleep Quality Index was used to evaluate sleep quality in all subjects. The serum concentrations of corticotrophin-releasing hormone (CRH), thyrotrophin-releasing hormone (TRH), GnRH, adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), cortisol, total triiodothyronine (TT3), and total thyroxine (TT4) in the morning (between 0730 h and 0800 h) were detected. Compared to the controls, all hormonal levels were elevated in the insomniacs, except ACTH and TSH in the PI group. Compared to the DCI patients, the PI patients had higher levels of CRH, cortisol, TT3, and TT4 but lower levels of TRH, GnRH, and ACTH. Spearman's correlation analysis indicated that CRH, TRH, GnRH, TSH, cortisol, TT4, and TT3 were positively correlated with the severity of insomnia. The linear regression analysis showed that only CRH, GnRH, cortisol, and TT3 were affected by the PSQI scores among all subjects, and only CRH was included in the regression model by the "stepwise" method in the insomnia patients. Our results indicated that PI patients may have over-activity of the hypothalamus-pituitary-adrenal/thyroid axes and an elevated level of GnRH in the morning.The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This study included 30 patients with primary insomnia (PI), 30 patients with depression-comorbid insomnia (DCI), and 30 healthy controls for exploring the alterations in the hypothalamus-pituitary-adrenal/thyroid axes' hormones and gonadotropin-releasing hormone (GnRH). The Pittsburgh Sleep Quality Index was used to evaluate sleep quality in all subjects. The serum concentrations of corticotrophin-releasing hormone (CRH), thyrotrophin-releasing hormone (TRH), GnRH, adrenocorticotropic hormone (ACTH), thyroid stimulating hormone (TSH), cortisol, total triiodothyronine (TT3), and total thyroxine (TT4) in the morning (between 0730 h and 0800 h) were detected. Compared to the controls, all hormonal levels were elevated in the insomniacs, except ACTH and TSH in the PI group. Compared to the DCI patients, the PI patients had higher levels of CRH, cortisol, TT3, and TT4 but lower levels of TRH, GnRH, and ACTH. Spearman's correlation analysis indicated that CRH, TRH, GnRH, TSH, cortisol, TT4, and TT3 were positively correlated with the severity of insomnia. The linear regression analysis showed that only CRH, GnRH, cortisol, and TT3 were affected by the PSQI scores among all subjects, and only CRH was included in the regression model by the "stepwise" method in the insomnia patients. Our results indicated that PI patients may have over-activity of the hypothalamus-pituitary-adrenal/thyroid axes and an elevated level of GnRH in the morning.
Audience Academic
Author Xia, Lan
Li, Zhi-Hua
Chen, Gui-Hai
Shen, Jianhua
Jiang, Song
AuthorAffiliation 2 Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
John Hopkins University School of Medicine, United States of America
1 Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
3 Sleep Research Laboratory, Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada
AuthorAffiliation_xml – name: 2 Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
– name: 3 Sleep Research Laboratory, Department of Psychiatry, University Health Network, University of Toronto, Toronto, Canada
– name: John Hopkins University School of Medicine, United States of America
– name: 1 Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, People’s Republic of China
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  surname: Jiang
  fullname: Jiang, Song
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  fullname: Shen, Jianhua
BackLink https://www.ncbi.nlm.nih.gov/pubmed/23951080$$D View this record in MEDLINE/PubMed
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2013 Xia et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
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Conceived and designed the experiments: G-HC JS. Performed the experiments: LX Z-HL. Analyzed the data: LX. Contributed reagents/materials/analysis tools: Z-HL SJ. Wrote the paper: LX.
Competing Interests: The authors have declared that no competing interests exist.
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Snippet The hypothalamus-pituitary-target gland axis is thought to be linked with insomnia, yet there has been a lack of further systematic studies to prove this. This...
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SubjectTerms Adrenocorticotropic hormone
Adrenocorticotropic Hormone - blood
Adult
Biology
Bipolar disorder
Brain research
Case-Control Studies
Clinical trials
Correlation analysis
Corticotropin
Corticotropin-releasing hormone
Corticotropin-Releasing Hormone - blood
Cortisol
Endocrinology
Eye movements
Family medical history
Female
Gene expression
Glucocorticoids
Glycoproteins
Gonadotropin-releasing hormone
Gonadotropin-Releasing Hormone - blood
Gonadotropins
Hormones
Hospitals
Humans
Hydrocortisone - blood
Hypothalamo-Hypophyseal System - metabolism
Hypothalamo-Hypophyseal System - physiopathology
Hypothalamus
Hypothyroidism
Insomnia
Male
Medical research
Medicine
Mental depression
Middle Aged
Morning
Neurology
Patients
Pituitary
Pituitary (anterior)
Pituitary-Adrenal System - metabolism
Pituitary-Adrenal System - physiopathology
Psychiatry
Regression analysis
Regression models
Releasing
Restless legs syndrome
Sleep
Sleep disorders
Sleep Initiation and Maintenance Disorders - blood
Sleep Initiation and Maintenance Disorders - physiopathology
Studies
Thyroid
Thyroid gland
Thyroid Gland - metabolism
Thyroid Gland - physiopathology
Thyroid hormones
Thyroid-stimulating hormone
Thyrotropin - blood
Thyrotropin-releasing hormone
Thyrotropin-Releasing Hormone - blood
Thyroxine
Thyroxine - blood
Triiodothyronine
Triiodothyronine - blood
Womens health
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Title Alterations in Hypothalamus-Pituitary-Adrenal/Thyroid Axes and Gonadotropin-Releasing Hormone in the Patients with Primary Insomnia: A Clinical Research
URI https://www.ncbi.nlm.nih.gov/pubmed/23951080
https://www.proquest.com/docview/1430258317
https://www.proquest.com/docview/1426019290
https://pubmed.ncbi.nlm.nih.gov/PMC3739817
https://doaj.org/article/f9fdff054146471cb2090982efb45e5c
http://dx.doi.org/10.1371/journal.pone.0071065
Volume 8
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