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Cited by 83Sleep and related disordersStress Responses and CortisolCircadian rhythm and melatonin

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

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Xia, Lan, Chen, Gui-Hai, Li, Zhi-Hua, Jiang, Song, Shen, Jianhua·2013·PLoS ONE
DOI 10.1371/journal.pone.0071065PMC PMC3739817
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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.

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  • Xia et al. showed a direct correlation between levels of TSH, T3, and T4 and the severity of insomnia symptoms.

    “Xia et al. (5) showed a direct correlation between levels of thyroid-stimulating hormone (TSH), T3, and T4 and the severity of insomnia symptoms.”

    From Thyroid Dysfunction and Sleep Disorders (2021) · cites this paper as [5]

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Authors
Xia, L., Chen, G.-H., Li, Z.-H., Jiang, S., & Shen, J.
Affiliations
  • First Affiliated Hospital of Anhui Medical University (CN)
  • University Health Network (CA)
Corresponding author
Chen, Gui-Hai
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2013-08-09
Volume
8
Issue
8
Pages
e71065
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0071065
PMC
PMC3739817
OpenAlex
W2059046933
Cited by
83
References
11
Citations by year
2026: 2 · 2025: 12 · 2024: 9 · 2023: 10 · 2022: 4 · 2021: 10 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 1 · 2013: 1
FWCI
6.32
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Anhui Medical University
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
primary insomnia, hypothalamic-pituitary-adrenal axis, hypothalamic-pituitary-thyroid axis, gonadotropin-releasing hormone, corticotropin-releasing factor, thyrotropin-releasing hormone, ACTH, thyroid-stimulating hormone, cortisol, triiodothyronine, thyroxine, sleep quality, insomnia severity
MeSH terms
Adrenocorticotropic Hormone, Adult, Corticotropin-Releasing Hormone, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Sleep Initiation and Maintenance Disorders, Gonadotropin-Releasing Hormone, Male, Middle Aged, Pituitary-Adrenal System, Thyroid Gland, Thyrotropin, Thyrotropin-Releasing Hormone, Thyroxine, Triiodothyronine, Case-Control Studies

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