The use and misuse of opioids are a growing global problem. Although the effects of these drugs on the human endocrine system have been studied for decades, attention on their related clinical consequences, particularly on the hypothalamic-pituitary system and bone health, has intensified over recent years. This Statement appraises research data related to the impact of opioids on the gonadal and adrenal function. Whereas hypogonadism is well recognized as a side effect of opioids, the significance of their inhibitory actions on the hypothalamic-pituitary-adrenal system and the occurrence of clinically relevant adrenal insufficiency is not fully elucidated. The often-inconsistent results of studies investigating how opioids affect the secretion of GH, prolactin, arginine vasopressin, and oxytocin are assessed. The accumulating evidence of opioid actions on bone metabolism and their negative sequelae on bone mineral density and risk of fracture are also reviewed. In each section, available data on diagnostic and management approaches for opioid endocrine sequelae are described. This Statement highlights a plethora of gaps in research associated with the effects and clinical consequences of opioids on the endocrine system. It is anticipated that addressing these gaps will improve the care of people using or misusing opioids worldwide. The Statement is not intended to serve as a guideline or dictate treatment decisions.

中文翻译：

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外源性阿片类药物和人类内分泌系统：内分泌学会科学声明。


阿片类药物的使用和误用是一个日益严重的全球性问题。尽管这些药物对人类内分泌系统的影响已经研究了几十年，但近年来对其相关临床后果的关注，特别是对下丘脑-垂体系统和骨骼健康的关注有所加强。本声明评估了与阿片类药物对性腺和肾上腺功能的影响相关的研究数据。虽然性腺功能减退症是公认的阿片类药物的副作用，但它们对下丘脑 - 垂体 - 肾上腺系统的抑制作用的重要性以及临床相关肾上腺皮质功能减退症的发生尚未完全阐明。评估了调查阿片类药物如何影响 GH、催乳素、精氨酸加压素和催产素分泌的研究结果通常不一致。还回顾了阿片类药物对骨代谢作用及其对骨密度和骨折风险的负面后遗症的积累证据。在每节中，都描述了有关阿片类药物内分泌后遗症诊断和管理方法的现有数据。本声明强调了与阿片类药物对内分泌系统的影响和临床后果相关的研究中存在大量空白。预计解决这些差距将改善对全球使用或滥用阿片类药物的人的护理。本声明不作为指南或支配治疗决策。