Urinary Catecholamine Excretion Research Articles

Dense-core vesicle proteins IA-2 and IA-2β affect renin synthesis and secretion through the β-adrenergic pathway

IA-2 and IA-2beta, major autoantigens in type 1 diabetes, are transmembrane proteins in dense-core vesicles, and their expression influences the secretion of hormones and neurotransmitters. The present experiments were performed to examine whether IA-2 and IA-2beta modulate the release of renin from dense-core vesicles of juxtaglomerular granular cells in the kidney. Plasma renin concentration (PRC; ng angiotensin I.ml(-1).h(-1)) was significantly reduced in mice with null mutations in IA-2, IA-2beta, or both IA-2 and IA-2beta compared with wild-type mice (876 +/- 113, 962 +/- 130, and 596 +/- 82 vs. 1,367 +/- 93; P < 0.01, P < 0.02, and P < 0.001). Renin mRNA levels were reduced to 26.4 +/- 5.1, 39 +/- 5.4, and 35.3 +/- 5.5% of wild-type in IA-2-/-, IA-2beta-/-, and IA-2/IA-2beta-/- mice. Plasma aldosterone levels were not significantly different among genotypes. The regulation of PRC by furosemide and salt intake, and of aldosterone by salt intake, was maintained in all genotypes. IA-2 and IA-2beta expression did not colocalize with renin but showed overlapping immunoreactivity with tyrosine hydroxylase. While propranolol reduced PRC in wild-type mice, it had no effect on PRC in IA-2/ IA-2beta-/- mice. Renal tyrosine hydroxylase mRNA and immunoreactivity were reduced in IA-2/IA-2beta-/- mice as was the urinary excretion of catecholamines. We conclude that IA-2 and IA-2beta are required to maintain normal levels of renin expression and renin release, most likely by permitting normal rates of catecholamine release from sympathetic nerve terminals.

Training and 24-hr Urinary Catecholamine Excretion

We examined the effects of 28 weeks of training on 24-hr urinary catecholamine excretion and mood (evaluated using the Recovery-Stress Questionnaire for Athletes RESTQ-Sport) among seven national young female tennis players. Data were collected after a 1-month rest (September, T (1)), 3 months after T1(T2) and 7 months after T1(T3). Standardized Stress and Standardized Recovery scores and RESTQ-Index were computed. The training load increased by 161 % between T1 and T2 and by 55 % between T2 and T3. The performance (wins/total number of matches) decreased throughout the study. Urinary catecholamine excretion presented an U-shaped curve with a significant increase in 24-hr urinary catecholamine excretions, and epinephrine/norepinephrine ratio from T1 to T2 (T1 vs. T2: epinephrine: + 100 %, p < 0.05; norepinephrine: + 30 %, p < 0.05. Then, at T3, urinary catecholamine excretions and the epinephrine/norepinephrine ratio decreased significantly to values lower than the values observed at T1. A decrease in RESTQ-Index throughout the study was mainly based on a large increase in the Standardized Stress score. Changes in specific stress and recovery scales of the RESTQ-Sport for athletes and changes in catecholamine values indicated a state of heavy training stress and incomplete recovery at the end of the study.

Translationale Forschung zur Erforschung der Pathophysiologie der Präeklampsie: Das autonome Nervensystem

Preeclampsia is responsible for a high incidence of fetal and maternal morbidity and mortality. The pathophysiological mechanisms of preeclampsia have still not been fully elucidated, but preeclampsia is associated with endothelial dysfunction. Since many decades, a causal relationship to the autonomic nervous system has been assumed. Several studies have investigated the excretion of catecholamines in urine and plasma. Due to conflicting results, the role of the autonomic nervous system could not be definitively resolved in these studies. However, microneurography has demonstrated a state of overactivity in women with preeclampsia. An additional study has shown that all women at risk for preeclampsia showed a gestational increase in muscle sympathetic nerve activity (MSNA), defined as pregnancy-induced sympathetic overactivity (PISO), which normalized after delivery. However, it remains unclear whether the sympathetic activity precedes preeclampsia or occurs only as a secondary phenomenon. Further consolidated research into the role of the autonomic nervous system might answer this question respecting the pathophysiological mechanism of preeclampsia and contribute to a more effective therapeutic regime.

Autonomic Nervous System Function in Chronic Exogenous Subclinical Thyrotoxicosis and the Effect of Restoring Euthyroidism

Knowledge on the relationship between the autonomic nervous system and subclinical hyperthyroidism is mainly based upon cross-sectional studies in heterogeneous patient populations, and the effect of restoration to euthyroidism in subclinical hyperthyroidism has not been studied. We investigated the long-term effects of exogenous subclinical hyperthyroidism on the autonomic nervous system and the potential effects of restoration of euthyroidism. This was a prospective single-blinded, placebo-controlled, randomized trial. The study was performed at a university hospital. A total of 25 patients who were on more than 10-yr TSH suppressive therapy after thyroidectomy was examined. Patients were studied at baseline and subsequently randomized to a 6-month thyroid hormone substitution regimen to obtain either euthyroidism or maintenance of the subclinical hyperthyroid state. Urinary excretion of catecholamines and heart rate variability were measured. Baseline data of the subclinical hyperthyroidism patients were compared with data obtained in patients with hyperthyroidism and controls. Urinary excretion of norepinephrine and vanillylmandelic acid was higher in the subclinical hyperthyroidism patients compared with controls and lower compared with patients with overt hyperthyroidism. Heart rate variability was lower in patients with hyperthyroidism, intermediate in subclinical hyperthyroidism patients, and highest in the healthy controls. No differences were observed after restoration of euthyroidism. Long-term exogenous subclinical hyperthyroidism has effects on the autonomic nervous system measured by heart rate variability and urinary catecholamine excretion. No differences were observed after restoration to euthyroidism. This may indicate the occurrence of irreversible changes or adaptation during long-term exposure to excess thyroid hormone that is not remedied by 6-month euthyroidism.

Urinary Cortisol and Catecholamine Excretion after Burn Injury in Children

A severe burn causes increased levels of urine cortisol and catecholamines. However, little is known about the magnitude of this increase or how and when the levels return to normal. The purpose of this study was to determine in a large clinical prospective trial the acute and long-term pattern of urine cortisol and catecholamine expression in severely burned children. Pediatric patients with burns greater than 40% total body surface area (TBSA), admitted to our unit over a 6-yr period, were included into the study. Clinical data including length of stay, number of operations, and duration and number of infections were determined. Patients had regular 24-h urine collections during their acute admission and reconstructive periods. Urine collections were analyzed for cortisol, epinephrine, and norepinephrine. Each urine cortisol was compared with age-adjusted reference ranges. Ninety-five percent confidence intervals and ANOVA analysis were used where appropriate. Two hundred twelve patients were included in the study (75 females and 137 males), with a mean +/- sem TBSA of 58 +/- 1% (third-degree 45 +/- 2%) and mean age of 9 +/- 0.4 yr. Urinary cortisol levels were significantly increased (3- to 5-fold) up to 100 d after the burn and then approached normal levels (P < 0.05). The rise in urine cortisol was significantly higher in male than female patients (P < 0.05). Early hypercortisolemia was associated with increased duration of severe infection (P < 0.05). Persistent hypercortisolemia was associated with increases in both infection rates and duration of severe infection (P < 0.05). Urinary catecholamines showed a significant increase at 11-20 d after the burn (P < 0.05). Urinary norepinephrine levels were significantly increased up to 20 d and then returned to normal (P < 0.05). Urinary levels of cortisol, epinephrine, and norepinephrine are significantly increased after a major burn. Early hypercortisolemia is associated with increased duration of severe infection. Persistent hypercortisolemia is associated with increases in both infection rates and duration of severe infection.

Perioperative management of late metastasis of pheochromocytoma in clavicle

Perioperative management of late metastasis of pheochromocytoma in clavicle

Regulator of G protein signalling 2 ameliorates angiotensin II‐induced hypertension in mice

Angiotensin II (Ang II) activates signalling pathways predominantly through the G-protein-coupled Ang II type 1 receptor (AT(1)R). The regulator of G protein signalling 2 (RGS2) is a negative G protein regulator. We hypothesized that RGS2 deletion changes blood pressure regulation by increasing the response to Ang II. To address this issue, we infused Ang II (0.5 mg kg(-1) day(-1)) chronically into conscious RGS2-deleted (RGS2(-/-)) and wild-type (RGS2(+/+)) mice, measured mean arterial blood pressure and heart rate (HR) with telemetry and assessed vasoreactivity and gene expression of AT(1A), AT(1B) and AT(2) receptors. Angiotensin II infusion increased blood pressure more in RGS2(-/-) than in RGS2(+/+) mice, while HR was not different between the groups, indicating a resetting of the baroreceptor reflex. Urinary catecholamine excretion was similar in Ang II-infused RGS2(-/-) and RGS2(+/+) mice, indicating a minor role of sympathetic tone for blood pressure differences. Myogenic tone and vasoreactivity in response to Ang II, endothelin-1 and phenylephrine were increased in isolated renal interlobar arterioles of RGS2(-/-) mice compared with RGS2(+/+) mice. The AT(1A), AT(1B) and AT(2) receptor gene expression was not different between RGS2(-/-) and RGS2(+/+) mice. Our findings suggest that RGS2 deletion promotes Ang II-dependent hypertension primarily through an increase of myogenic tone and vasoreactivity, probably by sensitization of AT(1) receptors.

Tyrosine Hydroxylase, the Rate-Limiting Enzyme in Catecholamine Biosynthesis

Tyrosine hydroxylase (TH) is the rate-limiting enzyme in catecholamine biosynthesis. Does common genetic variation at human TH alter autonomic activity and predispose to cardiovascular disease? We undertook systematic polymorphism discovery at the TH locus and then tested variants for contributions to sympathetic function and blood pressure. We resequenced 80 ethnically diverse individuals across the TH locus. One hundred seventy-two twin pairs were evaluated for sympathetic traits, including catecholamine production, reflex control of the circulation, and environmental (cold) stress responses. To evaluate hypertension, we genotyped subjects selected from the most extreme diastolic blood pressure percentiles in the population. Human TH promoter haplotype/reporter plasmids were transfected into chromaffin cells. Forty-nine single-nucleotide polymorphisms were discovered, but coding region polymorphism did not account for common phenotypic variation. A block of linkage disequilibrium spanned 4 common variants in the proximal promoter. Catecholamine secretory traits were significantly heritable (h2), as were stress-induced blood pressure changes. In the TH promoter, significant associations were found for urinary catecholamine excretion and for blood pressure response to stress. TH promoter haplotype 2 (TGGG) showed pleiotropy, increasing both norepinephrine excretion and blood pressure during stress. Coalescent simulations suggest that TH haplotype 2 likely arose approximately 380,000 years ago. In hypertension, 2 independent case-control studies (1266 subjects with 53% women and 927 subjects with 24% women) replicated the effect of C-824T in the determination of blood pressure. We conclude that human catecholamine secretory traits are heritable, displaying joint genetic determination (pleiotropy) with autonomic activity and finally with blood pressure in the population. Catecholamine secretion is influenced by genetic variation in the adrenergic pathway encoding catecholamine synthesis, especially at the classically rate-limiting step, TH. The results suggest novel pathophysiological links between a key adrenergic locus, catecholamine metabolism, and blood pressure and suggest new strategies to approach the mechanism, diagnosis, and treatment of systemic hypertension.

Parkinson's disease: the effect of L-dopa therapy on urinary free catecholamines and metabolites

L-dopa is an important antiparkinsonian drug. It is a precursor of dopamine and the other catecholamines. Potentially, administration of L-dopa could lead to increased urinary excretion of catecholamines and their metabolites to abnormal amounts. The current study aimed to determine these excretions in patients with Parkinson's disease (PD) receiving L-dopa compared with suitable controls. This is the first assessment of the effect of exogenous administration of L-dopa on urinary free metadrenalines. Using one-way analysis of variance (ANOVA), urine catecholamines and metabolites, expressed as mmol per mole creatinine, were compared in: patients with PD who were receiving L-dopa; patients with PD but not receiving L-dopa; and patients without PD who were being investigated for the presence of phaechromocytoma but were found not to have the disease. Significantly higher values for urinary dopamine, homovanillic acid, free normetadrenaline and free metadrenaline were found in patients with PD receiving L-dopa compared with the other two control groups. In all the patients with PD, these four analytes were significantly correlated with daily dose of L-dopa. L-dopa therapy can result in production of false positives for urinary excretion of dopamine, homovanillic acid, free normetadrenaline or free metadrenaline and thereby decrease the diagnostic value of these measurements in identifying phaeochromocytoma and related tumours.

Post-traumatic Stress Disorder in Children and Adolescents: From Sigmund Freud's “Trauma” to Psychopathology and the (Dys)metabolic Syndrome

Post-traumatic Stress Disorder (PTSD) is an anxiety syndrome that develops after exposure to traumatic life events. Symptoms include re-experience of the initial trauma, avoidance of stimuli associated with the trauma and symptoms of excessive arousal. Neuroendocrine studies in adults with PTSD have demonstrated that basal cerebrospinal fluid (CSF) CRH levels are elevated and urinary cortisol levels are variable--low in the majority of cases--whereas other studies demonstrate no differences in urinary and plasma cortisol concentrations. Urinary catecholamine excretion is higher in PTSD patients than those of control subjects and other psychiatric disorders. Children may differ from adults in their psychologic and physiologic responses to severe stressors. Also, exposure to stress during critical periods of development may have irreversible effects on behavioral maturation and may affect specific vulnerable brain areas, altering CNS development. Similar to findings in adult studies, PTSD in children is characterized by increased sympathetic nervous system (SNS) activity, as indicated by elevated norepinephrine levels in the periphery. High cortisol levels in urine or saliva have been reported in most studies of childhood PTSD, while prospective longitudinal studies concerning the natural history of neuroendocrine changes in pediatric PTSD after an acute stressor are limited. The identification of neurobiologic changes in response to early adverse experiences is of major importance for the prognosis, prevention, management, and treatment of children and adolescents at risk for or suffering from PTSD.

The kidney really does tell the brain what to do!

‘The brain renin–angiotensin system appears to be upregulated and may be involved in hypertension and sympathetic overactivity in the compensated stage of chronic renal failure rats by subtotal nephrectomy.’ Angiotensin II within the brain is recognized as being involved with autonomic control and regulation of sympathetic outflow to the kidney. Moreover, there is a body of evidence supporting the view that in kidney disease renal sensory receptors are activated and cause a sympatho-excitation contributing to the associated hypertension. The report by Nishimura et al. in this issue brings together these two concepts by providing evidence for a link between them. They have used a model of 5/6th nephrectomy in the spontaneously hypertensive rat, where renal failure develops rapidly, and shown that whereas the exacerbation of the hypertensive state suppresses the peripheral renin–angiotensin system, that existing in the hypothalamus and brain stem is enhanced. This in itself is a significant point in that it demonstrates that the two systems can be modulated independently of each other. Furthermore, the enhanced hypertension and urinary catecholamine excretion in the renal failure rats is prevented by dorsal rhizotomy, which interrupts sensory information from the kidney going to the brain. These observations reinforce the concept that the kidney can determine the level of sympathetic outflow to the periphery.

Renal Albumin Excretion

Albumin excretion marks early glomerular injury in hypertension. This study investigated heritability of albumin excretion in twin pairs and its genetic determination by adrenergic pathway polymorphism. Genetic associations used single nucleotide polymorphisms at adrenergic pathway loci spanning catecholamine biosynthesis, storage, catabolism, receptor action, and postreceptor signal transduction. We studied 134 single nucleotide polymorphisms at 46 loci for a total of >51,000 genotypes. Albumin excretion heritability was 45.2+/-7.4% (P=2x10(-7)), and the phenotype aggregated significantly with adrenergic, renal, metabolic, and hemodynamic traits. In the adrenergic system, excretions of both norepinephrine and epinephrine correlated with albumin. In the kidney, albumin excretion correlated with glomerular and tubular traits (Na(+) and K(+) excretion; fractional excretion of Na(+) and Li(+)). Albumin excretion shared genetic determination (genetic covariance) with epinephrine excretion, and environmental determination with glomerular filtration rate and electrolyte intake/excretion. Albumin excretion associated with polymorphisms at multiple points in the adrenergic pathway: catecholamine biosynthesis (tyrosine hydroxylase), catabolism (monoamine oxidase A), storage/release (chromogranin A), receptor target (dopamine D1 receptor), and postreceptor signal transduction (sorting nexin 13 and rho kinase). Epistasis (gene-by-gene interaction) occurred between alleles at rho kinase, tyrosine hydroxylase, chromogranin A, and sorting nexin 13. Dopamine D1 receptor polymorphism showed pleiotropic effects on both albumin and dopamine excretion. These studies establish new roles for heredity and environment in albumin excretion. Urinary excretions of albumin and catecholamines are highly heritable, and their parallel suggests adrenergic mediation of early glomerular permeability alterations. Albumin excretion is influenced by multiple adrenergic pathway genes and is, thus, polygenic. Such functional links between adrenergic activity and glomerular injury suggest novel approaches to its prediction, prevention, diagnosis, and treatment.

Characterisation of the sympathetic nervous system of Asian ( Elephas maximus) and African ( Loxodonta africana) elephants based on urinary catecholamine analyses

Assessing the welfare status of captive animals using non-invasive measurements of hormones is of growing interest because this can serve as an effective tool to facilitate the optimization of environmental and husbandry conditions. Both the African elephant ( Loxodonta africana) and the Asian elephant ( Elephas maximus) exhibit extremely low breeding success in captivity, and because elevated levels of stress may negatively influence reproductive functions, this study sought to establish a method for assessing sympathoadrenal activity in captive female elephants. We found a circadian variation in urinary noradrenaline (norepinephrine, NE), adrenaline (epinephrine, Epi) and dopamine (DA) under short day length. Peak activity of noradrenaline and dopamine was noted at 3 a.m. Adrenaline showed a biphasic pattern with a minor peak recorded at 3 a.m. and a major peak 9 a.m. Under long-day photoperiodic conditions, simultaneous peaks of noradrenaline and adrenaline were again noted at 3 a.m. whereas dopamine does not appear to have a distinct circadian pattern under long-day length. A transfer of two elephant cows resulted in a marked increase in urinary adrenaline and noradrenaline levels, confirming that the transfer represented a stressful event. During the peripartal period, noradrenaline concentrations increased and maximum concentrations were obtained at delivery. Daily measurements of urinary dopamine throughout the follicular phase revealed an increase in dopamine secretion close to ovulation. This increase might indicate a role of dopamine in the ovulatory mechanisms. These results suggest that changes in urinary catecholamine excretion reflect fluctuations in sympathoadrenal activity and may be a useful indicator of stress.

Urinary Catecholamine and Metanephrine to Creatinine Ratios in Healthy Dogs at Home and in a Hospital Environment and in 2 Dogs with Pheochromocytoma

Measurement of high concentrations of urine catecholamines and metanephrines is useful in diagnosing pheochromocytoma in humans. Stress increases catecholamine excretion in urine. Stress of a hospital visit increases urinary catecholamine and metanephrine excretion in dogs. Fourteen clinically normal dogs, 2 dogs with pheochromocytoma. Voided urine samples were collected by the owners 7 days before (t-7), during the hospital visit immediately after diagnostic procedures (t0), as well as 1 (t1) and 7 days (t7) after the hospital visit. Urine catecholamine and metanephrine concentrations were measured using high-pressure liquid chromatography and expressed as ratios to urine creatinine concentration. In client-owned dogs epinephrine and norepinephrine ratios at t0 were significantly higher compared with ratios at t7. Metanephrine and normetanephrine ratios at t-7, t0, and t1 did not differ significantly from each other; however, at t7 they were significantly lower compared to values at t-7. In staff-owned dogs no significant differences were detected among the different collecting time points for any variable. Metanephrine and normetanephrine ratios were significantly higher in client-owned dogs compared to staff-owned dogs at t-7, t0, and t1 but not at t7. Stress associated with a hospital visit and with the sampling procedure causes increases in urine catecholamine and metanephrine excretion. Urine collection for the diagnosis of pheochromocytoma probably should take place at home after adaptation to the sampling procedure.

Qigong reduces stress in computer operators

Chinese research indicates that the Qigong method reduces psychosomatic and physical symptoms through an effect on the sympathetic nervous system. The aim was to investigate the effects of Qigong on stress among computer operators. Ten women were included in a Qigong group and an equal number in a control group. Heart rate, blood pressure, and finger temperature were measured at the beginning and at the end of the working day during 5 weeks. twenty four-hours urine samples were collected in the first and last weeks to measure catecholamine excretion in urine. Participants kept a daily record of psychological measures of strain and weekly measures of stress levels. Qigong reduced noradrenaline excretion in urine (p<0.05), and influenced the heart rate and temperature, indicating reduced activity of the sympathetic nervous system. Moreover, Qigong reduced low-back symptoms (p<0.05). In conclusion, Qigong exercise may reduce stress at computerised work.

Heart Rate Variability, Training Variation and Performance in Elite Swimmers

The aim of the present study was to investigate the relationships between heart rate variability (HRV) changes and both training variations and performances in elite swimmers. A secondary purpose was to measure catecholamine urinary excretion in elite swimmers to validate the HRV indices of sympathetic activity during training. Thirteen swimmers (4 females and 9 males) were tested before and after 4 weeks of intense training (IT) and 3 weeks of reduced training (RT). At the end of each period, the swimmers participated in an official competition of their best event. Individual performances were expressed as percentage of the previous season's best performance. Spectral analysis was used to investigate RR interval variability. HRV indices failed to show any significant changes between the study periods (p>0.05). Pre-IT HF was correlated with performance (r=0.45; p=0.05) and HFnu (r=0.59; p<0.05) during RT. On the other hand, once RT was completed, HFnu was correlated positively to performance (r=0.81; p<0.01) and negatively to fatigue (r=- 0.63; p<0.03). Conversely, the indices of sympathetic activity, i.e., LFnu and LF/HF ratio were inversely related to performance (both r=- 0.81; p<0.01); total fatigue score was correlated to the changes in HFnu (r=- 0.63; p<0.03) and in the LF/HF ratio (r=0.58; p<0.05). Changes in the adrenaline/noradrenaline ratio over the follow-up period were related to the changes in the LF/HF ratio (r=0.45; p<0.03). In highly trained swimmers coping well with a training program, including 4 weeks of IT followed by 3 weeks of RT, HRV indices were unaltered. On the other hand, after the 3 weeks of RT, HFnu was positively related to performance and inversely related to the fatigue score. Thus, elevated initial HF levels could be important in the parasympathetic activity increases during taper and, hence, in swimming performance improvement.

Catecholamine Excretion and Circadian Blood Pressure Profile in Patients with Pheochromocytoma

Circadian blood pressure (BP) rhythm is often disturbed in patients with secondary forms of hypertension. The aim of the present article was to investigate changes in circadian BP profile parameters using two-step statistical approach by Fourier analysis in relation to day and night urinary catecholamine excretion in 35 patients with pheochromocytoma (mean age 42+/-19 years). Twenty-four-hour ambulatory BP measurements (ABPM) were obtained using the SpaceLabs 90,207 monitor. Daytime and night-time urine collection was obtained in all patients to determine circadian catecholamine excretion. Fourier analysis was applied to estimate measures of BP circadian rhythm in ABPM, including the highest (Max) and lowest (Min) systolic (SBP) and diastolic (DBP) BP values, norad (ampSBP, ampDBP), and early acrophase (APSBP, APDBP). The Fourier indices of circadian BP rhythm were: MaxSBP 153+/-28 mm Hg, MaxDBP 99+/-16 mm Hg, MinSBP 117+/-17 mm Hg, MinDBP 69+/-11 mm Hg, ampSBP 18+/-8 mm Hg, ampDBP 14+/-5 mm Hg, APSBP 10+/-5 (h), and APDBP 11+/-3 (h). Urine noradrenaline (NA), adrenaline (A), and dopamine (DA) excretion during the day (d) and night (n) were: dNA 103.5+/-89.8 microg/14 h, nNA 52+/-70.8 microg/10 h, dA 13.2+/-17.9 microg/14 h; nA 6.13+/-9.6 microg/10 h, dD 181.8+/-87.3 microg/14 h, and nD 89.3+/-59.8 microg/10 h. A positive correlation was observed between urine dNa excretion and MaxDBP (r=0.37, P<0.05), and urine nNA and urine dA excretion were correlated with APDBP (r=0.47, r=0.35, respectively, both P<0.05). Thus, in addition to the effect on mean 24-h BP values, catecholamines released by tumor may also disturb circadian BP rhythm in patients with pheochromocytoma.

Occupational Differences in Job Strain and Physiological Stress: Female Nurses and School Teachers in Hawaii

The two objectives are to test the hypothesis that women in a profession with low decision latitude will have greater catecholamine excretion and higher blood pressure than women in a profession with greater decision latitude, and to assess the influence of ethnicity on the occupational comparison. Premenopausal women who were either full-time teachers in public schools (teachers; N = 92) or nurses or nurse's aides (nurses; N = 55) in East Hawaii who were not currently taking antihypertensive medication had ambulatory blood pressure (BP) and urinary catecholamine excretion measured over an approximate 4-hour period at work and home and over an approximate 8-hour period overnight. The women also filled out the Job Content Questionnaire (JCQ). The nurses had significantly lower scores on the "decision latitude" subscale of the JCQ. After controlling for the effects of ethnicity, age, body mass index, JCQ subscale scores, smoking habits, and menopausal status in regression analyses, the nurses also had significantly higher mean systolic and diastolic BP both in work and home settings and higher mean rates of both norepinephrine and epinephrine excretion in all daily settings (p < .05). There were no significant ethnic differences in scores on the JCQ subscales, but Asian-Americans had significantly higher systolic BP in all daily settings and higher diastolic BP overnight (p < .05) than Euro-Americans. These results suggest that among professional women, physiological stress responses are significantly greater when occupation-related decision latitude is low (nurses) than when it is high (teachers). The physiological response to stress is carried over into the home and overnight settings when occupation-related decision latitude is low (nurses). Individual scores on the JCQ were not significantly related to physiological measures in this study, however. Inclusion of contrasting occupations may be necessary to properly evaluate the relationships between individually reported job strain and heightened physiological stress responses in studies of working women.

P3108 交感神経系に関する生体影響評価指標の検証 : 尿中カテコールアミン排泄量と唾液中クロモグラニンA濃度の比較(一般演題:ポスター,地方の時代の産業保健,第79回日本産業衛生学会)

P3108 交感神経系に関する生体影響評価指標の検証 : 尿中カテコールアミン排泄量と唾液中クロモグラニンA濃度の比較(一般演題:ポスター,地方の時代の産業保健,第79回日本産業衛生学会)

Effects of epidural administration of local anaesthetics or morphine on postoperative nitrogen loss and catabolic hormones

To examine the effects of postoperative epidural analgesia with local anaesthetics or morphine on the excess nitrogen loss after upper abdominal surgery and to assess the roles of catabolic hormones in the nitrogen loss, urinary excretion of nitrogen and catecholamines and plasma concentrations of cortisol and glucagon were measured in three groups of patients undergoing elective gastrectomy. Group G patients received the operation under general anaesthesia, and their postoperative pain was relieved by intermittent injections of analgesics. Group PE received prolonged epidural analgesia with local anaesthetics during and after surgery. Group EM received epidural analgesia intra-operatively and epidural morphine postoperatively. Urinary nitrogen excretion during the first three postoperative days was significantly less in the PE and EM groups than in the G group, and the PE group excreted slightly less nitrogen than the EM group. In the G group, urinary excretion of adrenaline increased mainly on the day of operation, and noradrenaline chiefly on postoperative days. These catecholamine responses were almost completely abolished in the PE group, and significantly inhibited in the EM group. Plasma cortisol response was most remarkable shortly after the operation and then decreased in all groups, but was significantly lower in the two epidural groups than in the G group throughout the study. Plasma glucagon increased postoperatively in all groups, and the increase was less pronounced in both epidural groups than in the G group. These results suggested that an elevated sympathetic activity, represented by increased noradrenaline excretion and elicited by painful nociceptive and sympathetic nervous afferents, is responsible for the postoperative nitrogen loss which is mediated by glucagon and cortisol.