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Karaca, Z., F. Tanriverdi, H. Atmaca, C. Gokce, G. Elbuken, A. Selcuklu, K. Unluhizarci, and F. Kelestimur. "Can basal cortisol measurement be an alternative to the insulin tolerance test in the assessment of the hypothalamic–pituitary–adrenal axis before and after pituitary surgery?" European Journal of Endocrinology 163, no. 3 (September 2010): 377–82. http://dx.doi.org/10.1530/eje-10-0229.
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BackgroundThe aims of this study were to evaluate the validity of preoperative basal serum cortisol levels measured in predicting preoperative adrenal insufficiency and also the validity of basal serum cortisol levels and early postoperative insulin tolerance test (ITT) in predicting postoperative adrenal insufficiency.MethodsThe study was prospectively designed and included 64 patients who underwent pituitary surgery for conditions other than Cushing's disease. An ITT was performed preoperatively, on the 6th postoperative day and at the 1st postoperative month. Basal serum cortisol levels were measured on the 2nd, 3rd, 4th, 5th, and 6th postoperative days.ResultsPatients with a preoperative basal cortisol level of <165 nmol/l (6 μg/dl) showed insufficient cortisol response and those with levels higher than 500 nmol/l (18 μg/dl) had sufficient cortisol response to the preoperative ITT. The positive predictive value of the ITT performed on the 6th postoperative day was 69.7%, and the negative predictive value in predicting adrenal insufficiency at the 1st postoperative month was 58%. Patients were considered to have an insufficient cortisol response to ITT at the 1st postoperative month if their basal cortisol levels were <193 nmol/l (7 μg/dl) or 220 nmol/l (8 μg/dl) or 193 nmol/l (7 μg/dl) or 165 nmol/l (6 μg/dl) or 83 nmol/l (3 μg/dl) on the 2nd–6th postoperative days respectively.ConclusionSerum basal cortisol levels may be used as the first-line test in the assessment of the hypothalamic–pituitary–adrenal axis both preoperatively and postoperatively. Dynamic testing should be limited to the patients with indeterminate basal cortisol levels.
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Lee, Hwa-Yong, Tomas J. Acosta, Michiyo Tanikawa, Ryosuke Sakumoto, Junichi Komiyama, Yukari Tasaki, Mariusz Piskula, Dariusz J. Skarzynski, Masafumi Tetsuka, and Kiyoshi Okuda. "The role of glucocorticoid in the regulation of prostaglandin biosynthesis in non-pregnant bovine endometrium." Journal of Endocrinology 193, no. 1 (April 2007): 127–35. http://dx.doi.org/10.1677/joe.1.06975.
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To determine whether glucocorticoids (GCs) play a role in regulating uterine function in cow, the present study examined the expression of mRNA encoding GC receptor (GC-R) α, 11β-hydroxysteroid dehydrogenase (11-HSD) type 1 and type 2, and the activity of 11-HSD1 in bovine endometrial tissue throughout the estrous cycle. We also studied the effects of cortisol on basal, oxytocin (OT)- and tumor necrosis factor-α (TNFα)-stimulated prostaglandin (PG) production. A quantitative real-time PCR analysis revealed that GC-Rα mRNA was expressed more strongly in the mid-luteal stage (days 8–12) than in the other stages. In contrast to GC-Rα mRNA expression, 11-HSD1 mRNA expression was greater in the follicular stage than in the other stages, whereas 11-HSD2 mRNA expression was lowest in the follicular stage. The activity of 11-HSD1 was greater in the follicular stage and estrus than in the other stages and was lowest in the mid-luteal stage. Cortisone was dose-dependently converted to cortisol in the cultured endometrial tissue. Although cortisol did not affect either the basal or OT-stimulated production of PGs in the cultured epithelial cells, the production of PGs stimulated by TNFα in the stromal cells was suppressed by cortisol (P < 0.05). Cortisol suppressed basal prostaglandin (PG)F2α without affecting basal PGE2 production in the stromal cells. The overall results suggest that the level of cortisol is locally regulated in bovine endometrium throughout the estrous cycle by 11-HSD1, and that cortisol could act as a luteoprotective factor by selectively suppressing luteolytic PGF2α production in bovine endometrium.
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Maffazioli, Giovana D. N., Tania A. S. S. Bachega, Sylvia A. Y. Hayashida, Larissa G. Gomes, Helena P. L. Valassi, Jose A. M. Marcondes, Berenice B. Mendonca, Edmund C. Baracat, and Gustavo A. R. Maciel. "Steroid Screening Tools Differentiating Nonclassical Congenital Adrenal Hyperplasia and Polycystic Ovary Syndrome." Journal of Clinical Endocrinology & Metabolism 105, no. 8 (June 12, 2020): e2895-e2902. http://dx.doi.org/10.1210/clinem/dgaa369.
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Abstract Purpose To analyze the performance of basal 17OH-progesterone (17OHP) levels versus the basal 17OHP/cortisol ratio in nonclassical congenital adrenal hyperplasia (NCAH) and polycystic ovary syndrome (PCOS) differential diagnosis. Basal 17OHP levels >10 ng/mL have been used to confirm NCAH diagnosis without the adrenocorticotropic hormone (ACTH) test; however, the optimal cutoff value is a matter of debate. Methods A cross-sectional study was performed at the endocrinology and gynecological endocrinology outpatient clinics of a tertiary hospital. A total of 361 patients with PCOS (age 25.0 ± 5.3 years) and 113 (age 19.0 ± 13.6 years) patients with NCAH were enrolled. Basal and ACTH-17OHP levels were measured by radioimmunoassay, and CYP21A2 molecular analysis was performed to confirm hormonal NCAH diagnosis. Receiver operating characteristic curve analysis compared basal 17OHP levels and the 17OHP/cortisol ratio between NCAH and PCOS patients. Results Basal 17OHP levels were higher in NCAH patients than in those with PCOS (8.85 [4.20-17.30] vs 1.00 [0.70-1.50] ng/mL; P < 0.0001), along with 17OHP/cortisol ratio (0.86 [0.47-1.5]) vs 0.12 [0.07-0.19]; P < 0.0001, respectively). Basal 17OHP levels and the 17OHP/cortisol ratio were strongly correlated in both groups (rho = 0.82; P < 0.0001). Areas under the curves for basal 17OHP levels (0.9528) and the 17OHP/cortisol ratio (0.9455) were not different to discriminate NCAH and PCOS (P > 0.05). Basal 17OHP level >5.4 ng/mL and 17OHP/cortisol ratio >2.90 had 100% specificity to identify NCAH. Main Conclusions Basal 17OHP levels >5.4 ng/mL can be used to perform differential diagnoses between NCAH and PCOS, dismissing the ACTH test. The basal 17OHP/cortisol ratio was not superior to basal 17OHP levels in this scenario.
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de Vries, Friso, Daniel J. Lobatto, Leontine E. H. Bakker, Wouter R. van Furth, Nienke R. Biermasz, and Alberto M. Pereira. "Early postoperative HPA-axis testing after pituitary tumor surgery: reliability and safety of basal cortisol and CRH test." Endocrine 67, no. 1 (September 25, 2019): 161–71. http://dx.doi.org/10.1007/s12020-019-02094-6.
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Abstract Purpose To assess the reliability and safety of a postsurgical evaluation strategy of adrenal function using CRH stimulation and basal cortisol concentrations after transsphenoidal pituitary surgery. Methods Retrospective cohort study of all patients undergoing endoscopic transsphenoidal surgery from 2010 to 2017, in whom early postoperative basal cortisol and/or CRH-stimulated cortisol secretion were available, including confirmation of adrenal function during follow-up. Patients with Cushing’s disease were excluded. Optimal test performances were assessed using ROC analysis. Results A total of 156 patients were included. Sensitivity and specificity of the CRH test were 78% and 90%, respectively, and 86% and 92% for basal cortisol, respectively, using an optimal cutoff of 220 nmol/L. Eight patients had false-negative test results with the CRH test (normal test but adrenal insufficient at follow-up), and six patients with basal cortisol, the majority of which had multiple pituitary hormone deficiencies and fluid imbalances. No clinical adverse events occurred in patients with false-negative test results. The diagnostic performance of a single basal cortisol measurement was superior to the CRH test. Conclusions The early postoperative basal cortisol is a safe and simple measurement to guide (dis)continuation of hydrocortisone replacement. However, disturbing factors, e.g., sodium balance disorders, contraceptives, untreated hypopituitarism, and illness impact the interpretation and in those cases this measure is unreliable. We propose an algorithm in which hydrocortisone replacement at discharge is based on basal cortisol <220 nmol/L on postoperative day 2 or 3 in a stable condition.
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Boesgaard, Søren, Claus Hagen, Anders Nyboe Andersen, Henning Djursing, and Mogens Fenger. "Cortisol secretion in patients with normoprolactinemic amenorrhea." Acta Endocrinologica 118, no. 4 (August 1988): 544–50. http://dx.doi.org/10.1530/acta.0.1180544.
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Abstract. Patients with functional amenorrhea have raised central dopaminergic activity and opioid-mediated GnRH inhibition leading to inhibition of hypothalamic-pituitary-ovarian function. In the present study, basal serum cortisol and ACTH levels were measured in normoprolactinemic amenorrheic patients with (N = 14) and without (N = 7) insulin-dependent diabetes mellitus. Basal serum cortisol levels was significantly (P < 0.01) elevated in patients with normoprolactinemic amenorrhea compared with normal women. Basal serum cortisol was significantly (P < 0.02) elevated in amenorheic diabetic patients compared with menstruating diabetic women. In the amenorrheic groups both cortisol and ACTH levels increased significantly (P <0.01) after dopamine D-2 receptor blockade, whereas no hormonal changes occurred in the control groups. It is concluded that patients with normoprolactinemic amenorrhea have elevated basal serum cortisol, the reason probably being hypersecretion of corticotropin-releasing hormone. Secondly that dopaminergic blockade with metoclopramide stimulates ACTH and cortisol secretion in patients presumed to have raised dopaminergic activity.
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Keller-Wood, M. "Inhibition of stimulated and basal ACTH by cortisol during ovine pregnancy." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 271, no. 1 (July 1, 1996): R130—R136. http://dx.doi.org/10.1152/ajpregu.1996.271.1.r130.
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In pregnant ewes, as in pregnant women, plasma adrenocorticotropic hormone (ACTH) and cortisol concentrations are increased. Inhibition of free cortisol concentrations by dexamethasone, a synthetic glucocorticoid, is reduced in pregnant women compared with nonpregnant women. These experiments were designed to test the hypothesis that basal and stimulated ACTH concentrations are less sensitive to negative feedback inhibition by cortisol in pregnant ewes than in nonpregnant ewes. Ewes were infused with vehicle and with cortisol at two different rates (1 and 2 micrograms.kg-1.min-1) for 1 h; plasma ACTH concentrations during and after the infusion and after subsequent stimulation by hypotension were measured. Basal plasma ACTH concentrations during a 2-h infusion of cortisol (2 micrograms.kg-1.min-1) were also measured in undisturbed ewes. Cortisol significantly inhibited both stimulated and basal ACTH. The degree of suppression of ACTH was not reduced in the pregnant ewes compared with the nonpregnant ewes. The results indicate that both basal and stimulated ACTH are sensitive to negative feedback inhibition by cortisol during ovine pregnancy.
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Žarković, Miloš, Svetlana Ignjatović, Marijana Dajak, Jasmina Ćirić, Biljana Beleslin, Slavica Savić, Mirjana Stojković, Petar Bulat, and Božo Trbojević. "Cortisol response to ACTH stimulation correlates with blood interleukin 6 concentration in healthy humans." European Journal of Endocrinology 159, no. 5 (November 2008): 649–52. http://dx.doi.org/10.1530/eje-08-0544.
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ObjectiveInterleukin 6 (IL6) has the ability to influence each level of the hypothalamo-pituitary–adrenocortical (HPA) axis. The aim of the study was to test whether IL6 concentration correlates with the adrenal cortex response to ACTH in healthy humans. We postulated that higher basal IL6 concentration would be associated with the higher cortisol response to the stimulation.Design and methodsBasal IL6 concentration was measured and a low dose (1 μg) ACTH test was performed to assess cortisol response. Twenty-seven apparently healthy subjects (11 male, 16 female, mean age 31.1 years, age range 22–47 years) were included in the study.ResultsData are presented as mean±s.e.m. Basal IL6 level was 0.84±0.10 pg/ml. Basal cortisol was 351.9±18.3 nmol/l. Maximal cortisol during synacthen test was 653.0±20.6 nmol/l. Maximal cortisol increment was 301.1±20.0 nmol/l. IL6 concentration was not correlated with basal or maximal cortisol concentration, but correlated significantly with cortisol increment (r=0.63, 95% confidence interval) 0.42–0.83).ConclusionsIn our study, we found that higher basal IL6 concentration is associated with the higher cortisol response to ACTH stimulation. Based on previous research and our data, IL6, even in low concentrations and under physiologic conditions, modulates adrenal cortex responsivity to ACTH. Therefore, it seems that immune modulation of HPA axis is also present under physiologic and not only pathologic conditions.
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Fletcher, Andrew J. W., Xiao Hong Ma, Wen X. Wu, Peter W. Nathanielsz, Hugh H. G. McGarrigle, Abigail L. Fowden, and Dino A. Giussani. "Antenatal glucocorticoids reset the level of baseline and hypoxemia-induced pituitary-adrenal activity in the sheep fetus during late gestation." American Journal of Physiology-Endocrinology and Metabolism 286, no. 2 (February 2004): E311—E319. http://dx.doi.org/10.1152/ajpendo.00158.2003.
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This study examined the effects of dexamethasone treatment on basal hypothalamo-pituitary-adrenal (HPA) axis function and HPA responses to subsequent acute hypoxemia in the ovine fetus during late gestation. Between 117 and 120 days (term: ∼145 days), 12 fetal sheep and their mothers were catheterized under halothane anesthesia. From 124 days, 6 fetuses were continuously infused intravenously with dexamethasone (1.80 ± 0.15 μg·kg–1·h–1 in 0.9% saline at 0.5 ml/h) for 48 h, while the remaining 6 fetuses received saline at the same rate. Two days after infusion, when dexamethasone had cleared from the fetal circulation, acute hypoxemia was induced in both groups for 1 h by reducing the maternal fraction of inspired O2. Fetal dexamethasone treatment transiently lowered fetal basal plasma cortisol, but not ACTH, concentrations. However, 2 days after treatment, fetal basal plasma cortisol concentration was elevated without changes in basal ACTH concentration. Despite elevated basal plasma cortisol concentration, the ACTH response to acute hypoxemia was enhanced, and the increment in plasma cortisol levels was maintained, in dexamethasone-treated fetuses. Correlation of fetal plasma ACTH and cortisol concentrations indicated enhanced cortisol output without a change in adrenocortical sensitivity. The enhancements in basal cortisol concentration and the HPA axis responses to acute hypoxemia after dexamethasone treatment were associated with reductions in pituitary and adrenal glucocorticoid receptor mRNA contents, which persisted at 3–4 days after the end of treatment. These data show that prenatal glucocorticoids alter the basal set point of the HPA axis and enhance HPA axis responses to acute stress in the ovine fetus during late gestation.
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Gariani, Karim, Pedro Marques-Vidal, Gérard Waeber, Peter Vollenweider, and François R. Jornayvaz. "Salivary cortisol is not associated with incident insulin resistance or type 2 diabetes mellitus." Endocrine Connections 8, no. 7 (July 2019): 870–77. http://dx.doi.org/10.1530/ec-19-0251.
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Background Excessive glucocorticoid secretion has been associated with type 2 diabetes mellitus (T2DM) and other features of the metabolic syndrome. We aimed to evaluate whether basal or evening salivary cortisol may predict the occurrence of incident insulin resistance (IR) or T2DM. Method This was a prospective, population-based study derived from the CoLaus/PsyCoLaus study including 1525 participants (aged 57.7 ± 10.3 years; 725 women). A total of 1149 individuals were free from T2DM at baseline. Fasting plasma glucose and insulin were measured after a follow-up of 5.3 years. Basal and evening salivary cortisol were measured at baseline. The association between basal or evening salivary cortisol level and incidence of IR or T2DM were analyzed by logistic regression, and the results were expressed for each independent variable as ORs and 95% CI. Results After a median follow-up of 5.3 years, a total of 376 subjects (24.7%) developed IR and 32 subjects (2.1%) developed T2DM. Basal and evening salivary cortisol divided in quartiles were not associated with incidence of IR or T2DM. Multivariable analysis for age, gender, body mass index, physical activity and smoking status showed no association between basal or evening salivary cortisol and incidence of IR or T2DM. Conclusion In the CoLaus/PsyCoLaus study of healthy adults, neither basal nor evening salivary cortisol was associated with incident IR or T2DM.
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Afsar, F. Sule, Figen Isleten, and Nihal Sonmez. "Children with Atopic Dermatitis Do Not Have More Anxiety or Different Cortisol Levels Compared with Normal Children." Journal of Cutaneous Medicine and Surgery 14, no. 1 (January 2010): 13–18. http://dx.doi.org/10.2310/7750.2010.09021.
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Background: The hypothalamic-pituitary-adrenal axis has an important immunoregulatory role under stress, and stressmediated anxiety has been reported to be associated with alterations in immune functions and attenuated cortisol levels in atopic dermatitis (AD) patients. Objective: We investigated serum basal cortisol and anxiety levels in pediatric AD patients and compared them with those of controls. Methods: Basal serum cortisol levels were measured in 36 pediatric AD patients (aged 9–16 years) and 36 control subjects (aged 9–15 years). Anxiety was assessed by the trait anxiety subscale (TAI-C) of the State-Trait Anxiety Inventory for Children. The severity of AD was assessed by the objective severity scoring of AD (SCORing Atopic Dermatitis [SCORAD]). Results: Data analysis showed no statistical difference for the basal serum cortisol levels ( p = .383) and the TAI-C ( p = .730) between the two groups. No significant correlation was found between the basal cortisol values and the TAI-C scores in the AD group ( p = .290). The SCORAD index was correlated with the TAI-C scores ( p < .05) but not correlated with the basal serum cortisol values in AD patients ( p = .06). Conclusion: Children with AD do not have more anxiety or different cortisol levels when compared with normal children, but the severe symptomatology of AD itself may cause anxiety levels to increase in children with AD.
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Ackermann, Sandra, Francina Hartmann, Andreas Papassotiropoulos, Dominique J. F. de Quervain, and Björn Rasch. "Associations between Basal Cortisol Levels and Memory Retrieval in Healthy Young Individuals." Journal of Cognitive Neuroscience 25, no. 11 (November 2013): 1896–907. http://dx.doi.org/10.1162/jocn_a_00440.
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Cortisol is known to affect memory processes. On the one hand, stress-induced or pharmacologically induced elevations of cortisol levels enhance memory consolidation. On the other hand, such experimentally induced elevations of cortisol levels have been shown to impair memory retrieval. However, the effects of individual differences in basal cortisol levels on memory processes remain largely unknown. Here we tested whether individual differences in cortisol levels predict picture learning and recall in a large sample. A total of 1225 healthy young women and men viewed two different sets of emotional and neutral pictures on two consecutive days. Both sets were recalled after a short delay (10 min). On Day 2, the pictures seen on Day 1 were additionally recalled, resulting in a long-delay (20 hr) recall condition. Cortisol levels were measured three times on Days 1 and 2 via saliva samples before encoding, between encoding and recall as well as after recall testing. We show that stronger decreases in cortisol levels during retrieval testing were associated with better recall performance of pictures, regardless of emotional valence of the pictures or length of the retention interval (i.e., 10 min vs. 20 hr). In contrast, average cortisol levels during retrieval were not related to picture recall. Remarkably during encoding, individual differences in average cortisol levels as well as changes in cortisol did not predict memory recall. Our results support previous findings indicating that higher cortisol levels during retrieval testing hinders recall of episodic memories and extend this view onto interindividual changes in basal cortisol levels.
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Limone, Pierpaolo, Maria Sinatra, Flavio Ceglie, and Lucia Monacis. "Associations between Personality Traits and Basal Cortisol Responses in Sailing Athletes." European Journal of Investigation in Health, Psychology and Education 11, no. 3 (July 24, 2021): 804–12. http://dx.doi.org/10.3390/ejihpe11030058.
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There is a paucity of literature regarding the psycho-physiological profiles of sailors on board. This study aimed at providing empirical evidence on the individual differences between bowmen and helmsmen taking into account a biopsychological perspective. To this purpose, sailors’ profiles were examined by focusing on the association between personality traits and basal cortisol. The sample was composed of 104 athletes (Mage = 21.32, SD = 0.098; F = 35%), who fulfilled a self-reported questionnaire including a socio-demographic section and the Big Five questionnaire. Cortisol samples were collected on the day before the competition, within 30 min after awakening. T-test analysis showed significant differences on cortisol levels: bowmen obtained higher levels on cortisol responses compared to helmsmen. No differences emerged on personality traits between athletes’ roles. Bivariate associations showed positive associations of cortisol responses with extraversion and conscientiousness in bowmen, whereas no significant associations of cortisol with personality traits were found in helmsmen. Regression analyses confirmed that sex and extraversion predicted higher level of cortisol responses. Results were discussed in terms of a bio-psychosocial theoretical approach and provided findings on the relationships between personality trait and the hypothalamus-pituitary adrenal (HPA) system in dinghy sailors. Suggestions for a more suitable selection of sailor roles were given to coaches in order to improve athletes’ performance.
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Staby, Ida, Jesper Krogh, Marianne Klose, Jonas Baekdal, Ulla Feldt-Rasmussen, Lars Poulsgaard, Jacob Bertram Springborg, and Mikkel Andreassen. "Pituitary function after transsphenoidal surgery including measurement of basal morning cortisol as predictor of adrenal insufficiency." Endocrine Connections 10, no. 7 (July 1, 2021): 750–57. http://dx.doi.org/10.1530/ec-21-0155.
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Introduction Patients with pituitary adenomas undergoing transsphenoidal surgery require pre- and post-surgery examination of pituitary hormones. There is currently no consensus on how to evaluate the adrenal axis post-surgery. The aims of this study were to investigate factors that may predict postoperative adrenal insufficiency (AI) and to investigate the overall effect of transsphenoidal surgery on pituitary function. Methods One hundred and forty-three consecutive patients who had undergone transsphenoidal surgery for pituitary adenomas were included. Data on tumour size, pituitary function pre-surgery, plasma basal cortisol measured within 48 h post-surgery and pituitary function 6 months post-surgery were collected. Patients with AI prior to surgery, perioperative glucocorticoid treatment, Cushing’s disease and no re-evaluation after 1 month were excluded (n = 93) in the basal cortisol analysis. Results Low plasma basal cortisol post-surgery, tumour size and previous pituitary surgery were predictors of AI (all P < 0.05). A basal cortisol cut-off concentration of 300 nmol/L predicted AI 6 months post-surgery with sensitivity and negative predictive value of 100%, specificity of 81% and positive predictive value of 25%. New gonadal, thyroid and adrenal axis insufficiencies accounted for 2, 10 and 10%, respectively. The corresponding recovery rates were 17, 7 and 24%, respectively Conclusion Transsphenoidal surgery had an overall beneficial effect on pituitary endocrine function. Low basal plasma cortisol measured within 48 h after surgery, tumour size and previous surgery were identified as risk factors for AI. Measurement of basal cortisol post-surgery may help to identify patients at risk of developing AI.
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MacIsaac, RJ, JG McDougall, and EM Wintour. "Cortisol feedback on ovine fetal ACTH secretion during the last fifth of gestation." Reproduction, Fertility and Development 1, no. 4 (1989): 337. http://dx.doi.org/10.1071/rd9890337.
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This study investigates the development of the feedback relationship between cortisol and ACTH in ovine fetuses at 117-119 (n = 5), 130-134 (n = 4) and 140-143 (n = 6) days of gestation. During the last 2 h of a 24 h cortisol (100 micrograms h-1) or saline (0.19 mL h-1) infusion, the fetal ACTH response to bolus oCRH injection (10 micrograms) was tested after the collection of basal ACTH and cortisol samples. Basal ACTH concentrations in un-infused or saline-infused fetuses were observed to progressively increase after 117-119 days of gestation. In contrast, a prepartum increase in cortisol concentrations could not be detected until after 130-133 days. Cortisol infusion significantly inhibited basal ACTH values at 130-133 and 140-143 but not at 117-119 days. In the two youngest age groups, cortisol infusion significantly inhibited the fetal ACTH response to oCRH. At 140-143 days, ACTH values after oCRH injection, were elevated to a similar extent during the saline or cortisol infusion. However, at 140-143 days there was evidence to suggest that the ACTH response to oCRH administered during the saline infusion was blunted when compared with earlier stages of gestation. This study suggests that the circulating, basal concentrations of both ACTH and cortisol increase during the last fifth of gestation in the ovine fetus. The exact nature of the prepartum feedback relationship that develops between these two hormones remains to be fully elucidated.
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Saoud, C. J., and C. E. Wood. "Modulation of ovine fetal adrenocorticotropin secretion by androstenedione and 17beta-estradiol." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 272, no. 4 (April 1, 1997): R1128—R1134. http://dx.doi.org/10.1152/ajpregu.1997.272.4.r1128.
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Parturition in sheep is initiated by increases in activity of the fetal hypothalamic-pituitary-adrenal axis. We have previously reported that cortisol negative feedback efficacy is decreased at the end of gestation. The present study was designed to test the hypothesis that increasing plasma estrogen and/or androgen concentrations in the fetus might increase plasma adrenocorticotropic hormone (ACTH) concentration, either by stimulating ACTH secretion or by altering the negative feedback effect of cortisol on ACTH. Fetal sheep were chronically catheterized and treated with no steroid (control), 17beta-estradiol, or androstenedione (each approximately 0.24 mg/day). After catheterization and implantation of steroid pellet, fetuses were subjected to two short (10 min) periods of sodium nitroprusside-induced hypotension with or without pretreatment with intravenous infusion of hydrocortisone sodium succinate (0.5 microg/min) to test fetal ACTH responsiveness to stress and cortisol negative feedback efficacy. Estradiol treatment significantly increased basal plasma ACTH and cortisol concentrations relative to control fetuses but did not interfere with the inhibition of ACTH secretion by cortisol. Fetal plasma ACTH responses to hypotension were significantly suppressed approximately 60% in both control and estradiol-treated groups. Androstenedione treatment significantly increased basal fetal plasma ACTH and decreased basal fetal plasma cortisol concentration. Androstenedione did not alter stimulated levels of fetal ACTH but did block the inhibition of stimulated ACTH by cortisol. We conclude that increased fetal cortisol and ACTH secretion at the end of gestation may be due to the combined effects of the gonadal steroids in that estradiol increases basal plasma ACTH secretion while androstenedione reduces cortisol negative feedback efficacy.
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Jiang, Yanping, Wendi Da, Shan Qiao, Quan Zhang, Xiaoming Li, Grace Ivey, and Samuele Zilioli. "Basal cortisol, cortisol reactivity, and telomere length: A systematic review and meta-analysis." Psychoneuroendocrinology 103 (May 2019): 163–72. http://dx.doi.org/10.1016/j.psyneuen.2019.01.022.
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Figueiredo, Patrícia, Eduarda Ramião, Andreia Azeredo, Diana Moreira, Ricardo Barroso, and Fernando Barbosa. "Relation between basal cortisol and reactivity cortisol with externalizing problems: A systematic review✰." Physiology & Behavior 225 (October 2020): 113088. http://dx.doi.org/10.1016/j.physbeh.2020.113088.
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Yip, Churn-Ern, Samuel A. Stewart, Fatima Imran, David B. Clarke, Arati Mokashi, Stephanie M. Kaiser, and Syed A. Imran. "The Role of Morning Basal Serum Cortisol in Assessment of Hypothalamic Pituitary-Adrenal Axis." Clinical & Investigative Medicine 36, no. 4 (August 1, 2013): 216. http://dx.doi.org/10.25011/cim.v36i4.19955.
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Purpose: The use of morning basal serum cortisol levels as an alternative to dynamic testing for assessment of hypothalamic-pituitary-adrenal (HPA) axis has previously been reported. The purpose of this study was to determine the lower and upper cutoff values that would obviate subsequent HPA axis testing. Methods: A single-centre, retrospective study from a tertiary care endocrinology clinic was conducted, analyzing data from 106 adult individuals referred for HPA axis testing who had undergone a 0800-0900 morning basal serum cortisol test followed by a standard dose (250 μg) adrenocorticotropin (ACTH) stimulation test. The ability of morning basal serum cortisol values to predict post-ACTH 30 or 60 minute peak cortisol value of > 500 or > 550 nmol/L was investigated. Results: A morning basal cutoff of < 128 nmol/L is sufficient for predicting a post-ACTH value < 550 nmol/L, and morning basal cutoff levels of > 243 nmol/L and > 266 nmol/L predict peak post-ACTH values of > 500 and > 550 nmol/L respectively, obviating the need for dynamic testing. Regression analysis further demonstrated the log-linear relationship between morning basal and peak levels, while also finding a significant decrease in peak post-ACTH levels for patients diagnosed with secondary hypothyroidism (76 nmol/L lower, p=0.003) or secondary hypogonadism (61 nmol/L lower, p=0.02). These data suggest that the risk of cortisol deficiency is significantly higher in individuals with additional pituitary insufficiencies. The odds ratios for cortisol deficiency in patients with history of isolated secondary hypothyroidism was 3.41 (p=0.015), with isolated secondary hypogonadism was 4.77 (p=0.002) and with both was 7.45 (p=0.0002). Conclusion: Morning basal serum cortisol levels show promise as an effective screening test for HPA insufficiency for most patients. Clinicians should consider the high probability of HPA insufficiency in patients with one or more pituitary insufficiencies.
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Jericó, Márcia Marques, Fernando Mathias Bento, Ricardo Duarte Silva, Felipe Braz de Siqueira Cardozo, Fabiano De Granville Ponce, Rogério Márcio Soila, Priscila Viau Furtado, and Fabrício Lorenzini Aranha Machado. "Adrenal function evaluation in critically ill dogs with low doses of synthetic ACTH." Brazilian Journal of Veterinary Research and Animal Science 57, no. 2 (August 7, 2020): e167299. http://dx.doi.org/10.11606/issn.1678-4456.bjvras.2020.167299.
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The hypothalamus-pituitary-adrenal axis function may be impaired in patients with critical illnesses, especially cases of sepsis, named critical illness-related corticosteroid insufficiency (CIRCI). This study examined the function of the hypothalamic-pituitary-adrenal axis in normal dogs (n = 10) and dogs with critical diseases (n = 16), through determinations of endogenous ACTH (adrenocorticotropic hormone), basal cortisol and cortisol after stimulation in low doses of synthetic ACTH (1.0μg/kg/IV). The stimulation test with ACTH dose tested was verified as effective for evaluation of adrenal function in healthy and sick dogs. Ill dogs differed from healthy dogs by presenting higher basal cortisol values. Eight sick dogs presented a decrease in endogenous ACTH, basal cortisol, or Δ-cortisol. No significant differences were found between the control groups and critically ill dogs for the values of endogenous ACTH, cortisol after stimulation or Δ-cortisol. We concluded that the stimulation test with low-dose ACTH was effective for evaluation of adrenal function, as well as the fact that a considerable portion of critically ill dogs studied here, especially with sepsis, had evidence of inadequate corticosteroid response to stress.
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Papanek, P. E., and H. Raff. "Physiological increases in cortisol inhibit basal vasopressin release in conscious dogs." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 266, no. 6 (June 1, 1994): R1744—R1751. http://dx.doi.org/10.1152/ajpregu.1994.266.6.r1744.
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Glucocorticoid deficiency leads to elevated plasma vasopressin (AVP), while chronic endogenous hypercortisolism may inhibit osmotically stimulated AVP, suggesting that glucocorticoids may be feedback inhibitors of AVP secretion. We evaluated the effect of physiological increases in cortisol (65 mg/day iv) for 7 days on basal AVP and oxytocin (OT) in five conscious, male dogs. Cortisol increased from 1.3 +/- 0.1 to 5.0 +/- 0.8 micrograms/dl during infusion. Basal plasma AVP significantly decreased from 3.5 +/- 0.2 to 2.6 +/- 0.3 pg/ml during cortisol infusion. Plasma OT, osmolality, and sodium did not change while arterial pressure decreased (from 107 +/- 3 to 102 +/- 2 mmHg) on days 4 and 6. Increases in cortisol led to a physiologically significant, nonosmotic decrease in AVP. The effect was specific to AVP and independent of changes in arterial pressure. Glucocorticoid administration significantly decreased basal AVP within 24 h, which is comparable to the negative feedback control of adrenocorticotropic hormone. The inverse relationship between cortisol and AVP may account for the nonosmotic change in AVP in patients with disorders of glucocorticoid secretion.
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Castro-Sepulveda, Mauricio, Jorge Cancino, Rodrigo Fernández-Verdejo, Cristian Pérez-Luco, Sebastian Jannas-Vela, Rodrigo Ramirez-Campillo, Juan Del Coso, and Hermann Zbinden-Foncea. "Basal Serum Cortisol and Testosterone/Cortisol Ratio Are Related to Rate of Na+ Lost During Exercise in Elite Soccer Players." International Journal of Sport Nutrition and Exercise Metabolism 29, no. 6 (November 1, 2019): 658–63. http://dx.doi.org/10.1123/ijsnem.2019-0129.
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During exercise, the human body maintains optimal body temperature through thermoregulatory sweating, which implies the loss of water, sodium (Na+), and other electrolytes. Sweat rate and sweat Na+ concentration show high interindividual variability, even in individuals exercising under similar conditions. Testosterone and cortisol may regulate sweat Na+ loss by modifying the expression/activity of the cystic fibrosis transmembrane conductance regulator. This has not been tested. As a first approximation, the authors aimed to determine whether basal serum concentrations of testosterone or cortisol, or the testosterone/cortisol ratio relate to sweat Na+ loss during exercise. A total of 22 male elite soccer players participated in the study. Testosterone and cortisol were measured in blood samples before exercise (basal). Sweat samples were collected during a training session, and sweat Na+ concentration was determined. The basal serum concentrations of testosterone and cortisol and their ratio were (mean [SD]) 13.6 (3.3) pg/ml, 228.9 (41.4) ng/ml, and 0.06 (0.02), respectively. During exercise, the rate of Na+ loss was related to cortisol (r = .43; p < .05) and to the testosterone/cortisol ratio (r = −.46; p < .01), independently of the sweating rate. The results suggest that cortisol and the testosterone/cortisol ratio may influence Na+ loss during exercise. It is unknown whether this regulation depends on the cystic fibrosis transmembrane conductance regulator.
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Sloboda, Deborah M., Timothy J. M. Moss, Shaofu Li, Dorota Doherty, Ilias Nitsos, John R. G. Challis, and John P. Newnham. "Prenatal betamethasone exposure results in pituitary-adrenal hyporesponsiveness in adult sheep." American Journal of Physiology-Endocrinology and Metabolism 292, no. 1 (January 2007): E61—E70. http://dx.doi.org/10.1152/ajpendo.00270.2006.
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Fetal exposure to synthetic glucocorticoids in sheep results in increased fetal hypothalamic-pituitary-adrenal (HPA) activity persisting to one year of age. We aimed to determine the effects of single or repeated maternal or fetal betamethasone injections on offspring HPA activity at 2 and 3 yr of age and whether changes in adrenal mediators of steroidogenesis contribute to changes in pituitary-adrenal function. Pregnant ewes or their fetuses received either repeated intramuscular saline or betamethasone injections (0.5 mg/kg) at 104, 111, 118, and 124 days of gestation (dG) or a single betamethasone injection at 104 dG followed by saline at 111, 118, and 124 dG. Offspring were catheterized at 2 and 3 yr of age and given corticotrophin-releasing hormone + arginine vasopressin challenges. Adrenal tissue was collected for quantitative RT-PCR mRNA determination at 3.5 yr of age. In 2-yr-old offspring, maternal betamethasone injections did not alter basal ACTH or cortisol levels, but repeated injections elevated ACTH responses. At 3 yr of age, basal ACTH was elevated, and both basal and stimulated cortisol levels were suppressed by repeated maternal injections. Basal and stimulated cortisol-to-ACTH ratios and basal cortisol-to-cytochrome P-450 17α-hydroxylase (P450c17) mRNA ratios were suppressed by repeated injections. Repeated fetal betamethasone injections attenuated basal ACTH and cortisol levels in offspring at 2 but not 3 yr of age. Plasma changes were not associated with altered adrenal P450c17, ACTH receptor, β-hydroxysteroid dehydrogenase, or glucocorticoid receptor mRNA levels. These data suggest that maternal, but not fetal, betamethasone administration results in adrenal suppression in adulthood.
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Scacchi, Massimo, Leila Danesi, Agnese Cattaneo, Elena Valassi, Francesca Pecori Giraldi, Piero Radaelli, Alberto Ambrogio, et al. "The pituitary–adrenal axis in adult thalassaemic patients." European Journal of Endocrinology 162, no. 1 (January 2010): 43–48. http://dx.doi.org/10.1530/eje-09-0646.
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ObjectiveWe previously described in young thalassaemic patients an altered cortisol and ACTH responsiveness suggesting an impaired adrenocortical reserve. Owing to iron overload, a worsening of adrenal function should be expected in adult patients.DesignIn 124 adults with β-thalassaemia, urinary free cortisol (UFC) and plasma ACTH levels were determined and compared with those measured in 150 controls. In 45 patients, cortisol was measured in response to: i) tetracosactide 1 μg as an i.v. bolus (low-dose test, LDT) and ii) tetracosactide 250 μg infused i.v. over 8 h (high-dose test, HDT).ResultsUFC and serum cortisol were within the reference range in all patients. Conversely, basal plasma ACTH values were above the upper limit of the normal range in 19 patients. There were no statistically significant differences in the mean values of UFC, basal serum cortisol and plasma ACTH between patients and controls. A subnormal cortisol response to the LDT was registered in 18 out of 56 patients. Three of these patients also displayed a subnormal response to the HDT, together with elevated baseline plasma ACTH levels. In the LDT, a positive correlation was found between basal and peak cortisol values (P<0.0001). The latter were negatively correlated with basal ACTH values in both LDT (P<0.0001) and HDT (P<0.0001).ConclusionsAdult thalassaemic patients often present a subtle impairment of adrenocortical function. This may become clinically relevant in case of major stressful events. Thus, we recommend an assessment of adrenocortical function in all adult thalassaemic patients.
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Sólyom, J., G. Gács, K. Keszei, K. Láng, J. Örley, I. Petheö, and L. Ságodi. "Detection of late-onset adrenal hyperplasia in girls with peripubertal virilization." Acta Endocrinologica 115, no. 3 (July 1987): 413–18. http://dx.doi.org/10.1530/acta.0.1150413.
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Abstract. We investigated the value of serum levels of adrenal steroids (dehydroepiandrosterone sulphate, testosterone, 17-hydroxyprogesterone, cortisol) in the identification in peripubertal females with late-onset congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Among 68 females (age 3–18 years) with virilization in childhood, peripubertally or postpubertally, we selected 21 girls for an ACTH test by measurement of basal blood-spot or serum 17-hydroxyprogesterone (17-OHP) levels. Eight of 21 patients had supranormal post-ACTH serum 17-OHP concentration (57–153 nmol/l) with low normal cortisol concentration. All of them had supranormal basal and post-ACTH 17-OHP to cortisol ratios. These data show a relatively high incidence (about 12%) of mild 21-hydroxylase deficiency among prepubertal and adolescent girls with virilization. It is concluded that the first step in the investigation of peripubertally virilized girls should be the determination of serum 17-OHP and cortisol. Patients with basal morning 17-OHP concentration and 17-OHP to cortisol ratio above reference range should be given an ACTH test.
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Silva, Ivani N., Cristiane F. Cunha, Francisca L. Finch, and Enrico A. Colosimo. "Avaliação da recuperação do eixo hipotalâmico-hipofisário-adrenal após corticoterapia por meio do cortisol basal." Arquivos Brasileiros de Endocrinologia & Metabologia 50, no. 1 (February 2006): 118–24. http://dx.doi.org/10.1590/s0004-27302006000100017.
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A suspensão da corticoterapia é a causa mais comum de insuficiência supra-renal, e ainda persistem dúvidas quanto à melhor forma de avaliação da inibição e recuperação do eixo hipotalâmico-hipofisário-adrenal (HHA) provocada pelos glicocorticóides. O objetivo deste estudo foi avaliar a utilidade da dosagem do cortisol basal na avaliação desta insuficiência. Foram avaliadas 35 crianças (mediana da idade de 6,9 anos) submetidas ao tratamento preconizado pelo Grupo Brasileiro para o tratamento da Leucemia Linfocítica Aguda (LLA). O teste de estímulo com o hormônio liberador da corticotrofina (CRH 1 mcg/kg) foi realizado antes da introdução da dexametasona (6 mg/m²/dia, por 28 dias), no 8º e no 28º dias do uso do glicocorticóide e 48 horas e um mês após sua retirada. Houve inibição da secreção do cortisol basal e da concentração máxima (após CRH) durante a corticoterapia e 48 horas após sua suspensão, em relação ao valor obtido antes do tratamento (p< 0,01 e p< 0,0001, respectivamente, para os três exames). Um mês após o término da corticoterapia, o valor do cortisol basal e a concentração máxima não apresentavam diferença significativa em relação ao aferido antes do tratamento. Observou-se correlação positiva e significativa entre as concentrações basais e máximas do cortisol em todos os testes realizados. Observou-se, ainda, que ao considerarmos o limite inferior de cortisol basal de 8,5 mcg/dl obtivemos 95% de especificidade para o diagnóstico da insuficiência adrenal. Concluímos que o uso do cortisol basal é de utilidade como marcador da função supra-renal em crianças durante a suspensão do tratamento e após corticoterapia.
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Polovina, Tanja Skoric, Ivana Kraljevic, Mirsala Solak, Annemarie Balasko, Arta Haxhiu, Arita Haxhiu, Tina Dusek, Tamara Poljicanin, and Darko Kastelan. "Early Basal Cortisol Level as a Predictor of Hypothalamic-Pituitary-Adrenal (HPA) Axis Function After Pituitary Tumor Surgery." Experimental and Clinical Endocrinology & Diabetes 128, no. 11 (May 15, 2019): 709–14. http://dx.doi.org/10.1055/a-0885-1568.
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Abstract Purpose The purpose of this study was to evaluate the clinical relevance of the early postoperative basal cortisol level in assessing the postoperative hypothalamic-pituitary-adrenal (HPA) axis function after pituitary tumor surgery. Methods We performed a prospective observational study that enrolled 83 patients operated for pituitary adenoma or other sellar lesions at the University Hospital Center Zagreb between December 2013 and April 2017 (44 nonfunctioning pituitary adenomas, 28 somatotropinomas, 5 craniopharyngiomas, 2 prolactinomas resistant to medical therapy and 4 other lesions - Rathke's cleft cyst, arachnoid cyst, chondroma and gangliocytoma). Exclusion criteria were Cushing's disease, chronic therapy with glucocorticoids prior to surgery and preoperative adrenal insufficiency. Early postoperative basal cortisol levels (measured on the second postoperative day) and the Synacthen stimulation test (performed 3 months after the surgery with the peak cortisol level of>500 nmol/L considered as a normal response) were analyzed to assess HPA axis function during follow-up. Results ROC analysis showed a cut-off of the basal cortisol level of ≥300 nmol/L measured on the second postoperative day to predict normal postoperative HPA axis function with the sensitivity of 92.31%, specificity of 87.14% and positive predictive value of 57.14%. Conclusion The basal cortisol level on the second postoperative day is a valuable tool to predict integrity of the HPA axis after pituitary tumor surgery. Our data suggest that the cortisol level of ≥300 nmol/L accurately predicts adrenal sufficiency and that in these patients glucocorticoid therapy can be withdrawn.
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Sugaya, Nagisa, Shuhei Izawa, Namiko Ogawa, Kentaro Shirotsuki, and Shusaku Nomura. "Association between hair cortisol and diurnal basal cortisol levels: A 30-day validation study." Psychoneuroendocrinology 116 (June 2020): 104650. http://dx.doi.org/10.1016/j.psyneuen.2020.104650.
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Kertes, Darlene A., Megan R. Gunnar, Nicole J. Madsen, and Jeffrey D. Long. "Early deprivation and home basal cortisol levels: A study of internationally adopted children." Development and Psychopathology 20, no. 2 (2008): 473–91. http://dx.doi.org/10.1017/s0954579408000230.
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AbstractAnimal studies reveal that early deprivation impairs regulation of the hypothalamic–pituitary–adrenocortical (HPA) axis, potentially increasing vulnerability to stressors throughout life. To examine early deprivation effects on basal HPA axis activity in humans, basal cortisol levels were examined in 164 internationally adopted children who had experienced varying degrees of preadoption deprivation. Duration of institutional care, age at adoption, and parent ratings of preadoption neglect indexed a latent factor ofDeprived Care.Adoption measures of height and weight standardized to World Health Organisation norms indexed a latent factor ofGrowth Delaythat was viewed as another reflection of deprivation. Cortisol samples were collected 3.3–11.6 years postadoption (Md= 7.3 years) at home on 3 days approximately 30 min after wakeup and before bedtime. Both early a.m. levels and the decrease in cortisol across the day were examined. A structural equation model revealed that preadoption Deprived Care predicted Growth Delay at adoption and Growth Delay predicted higher morning cortisol levels and a larger diurnal cortisol decrease.
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Doi, Suhail AR, Ibrahim Lasheen, Khaldoon Al-Humood, and Kamal AS Al-Shoumer. "Relationship between Cortisol Increment and Basal Cortisol: Implications for the Low-Dose Short Adrenocorticotropic Hormone Stimulation Test." Clinical Chemistry 52, no. 4 (April 1, 2006): 746–49. http://dx.doi.org/10.1373/clinchem.2005.061267.
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Abstract Background: We analyzed the low-dose (1 μg) rapid adrenocorticotropic hormone test (LDST) in 17 patients with a normal hypothalamic-pituitary-adrenal axis to determine reference intervals for the LDST on the basis of poststimulation cortisol increments. Methods: We analyzed test results for 17 patients (14 females and 3 males; age range, 18–46 years) who had received a 2-mL aliquot of low-dose (1 μg) adrenocorticotropic hormone prepared from one 250-μg vial of Synacthen diluted in 500 mL of sterile normal saline solution. Sampling took place at 0, 20, 30, and 60 min post stimulation. The cortisol increment was plotted against basal cortisol. Results: We observed a marked interdependence of the basal cortisol concentration with the increase in cortisol concentration. The relationship was inverse and linear with the best fit observed at 30 min post stimulation. The lower 95% prediction limit for basal cortisol at the zero increment was 400 nmol/L with a mean concentration of 600 nmol/L. Conclusions: We propose that a peak cortisol concentration <400 nmol/L is a sufficient single criterion for abnormal adrenal function as assessed by the LDST. Concentrations of 400–600 nmol/L are in the gray area, and those >600 nmol/L confirm normal adrenal function. Repeat analyses with larger sample sizes are warranted to confirm these observations.
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Rakici, Hali. "Adrenal Insufficiency in Cirrhosis Patients: Evaluation of 108 Case Series." Euroasian Journal of Hepato-Gastroenterology 7, no. 2 (2017): 150–53. http://dx.doi.org/10.5005/jp-journals-10018-1237.
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ABSTRACT Aim Adrenal insufficiency (AI) in cirrhosis is an issue that has recently gained momentum. It can be seen in both stable and critically ill (sepsis, septic shock, and gastrointestinal system bleeding) cirrhotic patients. Its prevalence exists in a wide range since standardization of diagnostic methods is lacking. We aimed to scrutinize this issue in a 108 case series. Materials and methods We studied the presence of AI and its stage in patients with cirrhosis and its complications by using cross-sectional study. Standard-dose short synacthen test (SD-SST) was performed in 108 patients that had Child C decompensated cirrhosis without critical illness and it was aimed to determine the prevalence of AI based on basal cortisol, peak cortisol, and delta cortisol (basal total cortisol minus peak cortisol after stimulation) levels. Results The prevalence of AI in cirrhosis was found to be 25% based on basal cortisol level of <140 nmol/L, 22.2% based on delta cortisol level of <250 nmol/L, and 29.6% based on peak cortisol level of <500 nmol/L. Conclusion Prevalence of AI shows variation in decompensated cirrhosis without critical illness depending on different measures used. More definite results can be obtained when more standardized criteria are widely put into use. How to cite this article Rakici H. Adrenal Insufficiency in Cirrhosis Patients: Evaluation of 108 Case Series. Euroasian J Hepato-Gastroenterol 2017;7(2):150-153.
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Castro-Sepulveda, Mauricio, Jorge Cancino, Sebastian Jannas-Vela, Francisca Jesam, Casandra Lobos, Juan Del Coso, and Hermann Zbinden-Foncea. "Role of Basal Hormones on Sweat Rate and Sweat Na+ Loss in Elite Women Soccer Players." International Journal of Sports Medicine 41, no. 10 (May 26, 2020): 646–51. http://dx.doi.org/10.1055/a-1165-2072.
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AbstractWe aimed to determine whether basal concentrations of testosterone, cortisol or the ratio testosterone/cortisol were related to sweat Na+ loss, sweat Na+ concentration ([Na+]) and sweat rate during exercise. Twenty-two female elite soccer players participated in the study. Testosterone and cortisol were measured in blood samples before exercise. Sweat samples were collected during a training session (~20°C, ~30% RH, and ~0.55 m/s of wind speed) to measure sweat [Na+]. Sweat rate was determined by considering the difference between post-and pre-body weight, along with the amount of liquid consumed. During exercise, sweat Na+ loss (0.33[0.19] g/h) and sweat rate (0.49[0.20] L/h) were related to basal testosterone concentration (1.4[0.4] pg/mL) (r=0.54; r=0.55, respectively; p<0.05), but not with basal cortisol concentration (119.2[24.2] ng/mL) nor testosterone/cortisol ratio (0.012[0.003]) (p>0.05). However, when Na+ loss was adjusted to sweat rate, no association was found between Na+ loss and testosterone (p>0.05). In addition, no differences were found between players with high vs. low Na+ loss adjusted to sweat loss in menstrual phase or intensity during exercise (p>0.05). In conclusion, these results suggest that in these specific environmental conditions, basal levels of testosterone might increase sweat rate and therefore, the amount of Na+ lost during exercise in elite women soccer players.
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Pereira, Gabriela Magalhães, Nayron Medeiros Soares, Andreo Rysdyk de Souza, Jefferson Becker, Alessandro Finkelsztejn, and Rosa Maria Martins de Almeida. "Basal cortisol levels and the relationship with clinical symptoms in multiple sclerosis: a systematic review." Arquivos de Neuro-Psiquiatria 76, no. 9 (September 2018): 622–34. http://dx.doi.org/10.1590/0004-282x20180091.
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ABSTRACT Multiple sclerosis (MS) is a demyelinating, progressive and neurodegenerative disease. A disturbance on the hypothalamic-pituitary-adrenal axis can be observed in patients with MS, showing altered cortisol levels. We aimed to identify basal cortisol levels and verify the relationship with clinical symptoms in patients with MS. A systematic search was conducted in the databases: Pubmed, Web of Science and SCOPUS. Both higher and lower cortisol levels were associated with MS. Higher cortisol levels were associated with depression and anxiety, while lower levels were associated with depression, fatigue and urinary dysfunction. Higher cortisol levels may be associated with the progression and severity of MS.
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Ramirez, Luis F., Richard A. McCormick, and Martin T. Lowy. "Plasma Cortisol and Depression in Pathological Gamblers." British Journal of Psychiatry 153, no. 5 (November 1988): 684–86. http://dx.doi.org/10.1192/bjp.153.5.684.
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Basal serum cortisol and dexamethasone suppression test (DST) results were studied in 21 pathological gamblers who varied on the Beck Depression Inventory and selected scales of the Minnesota Multiphasic Personality Inventory, which had previously been shown to be related to depression in gamblers. All subjects were suppressors on the DST. There was a significant relationship between fluctuation in 08.00 h and 16.00 h basal cortisol levels and the psychological measures, suggesting a subtype of pathological gambler with potential clinical significance.
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Hering, Rachel, Irit Gilad, Z. Laron, and A. Kuritzky. "Effect of Sodium Valproate on The Secretion of Prolactin, Cortisol and Growth Hormone in Migraine Patients." Cephalalgia 12, no. 4 (August 1992): 257–58. http://dx.doi.org/10.1046/j.1468-2982.1992.1204257.x.
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A single oral dose of 500 mg sodium valproate had no effect on prolactin, growth hormone and cortisol secretion in 10 migraine patients when compared with five healthy controls and four migraine patients receiving placebo. Basal values of prolactin (PRL), cortisol and growth hormone (GH) were within the normal range, though PRL basal levels were lower in three patients (21.5%) in the migraine group.
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Korszun, A., E. A. Young, K. Singer, N. E. Carlson, M. B. Brown, and L. Crofford. "Basal Circadian Cortisol Secretion in Women with Temporomandibular Disorders." Journal of Dental Research 81, no. 4 (April 2002): 279–83. http://dx.doi.org/10.1177/154405910208100411.
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Lupien, S., AR Lecours, I. Lussier, G. Schwartz, NP Nair, and MJ Meaney. "Basal cortisol levels and cognitive deficits in human aging." Journal of Neuroscience 14, no. 5 (May 1, 1994): 2893–903. http://dx.doi.org/10.1523/jneurosci.14-05-02893.1994.
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Crowley, S., P. C. Hindmarsh, J. W. Honour, and C. G. D. Brook. "Reproducibility of the cortisol response to stimulation with a low dose of ACTH(1–24): the effect of basal cortisol levels and comparison of low-dose with high-dose secretory dynamics." Journal of Endocrinology 136, no. 1 (January 1993): 167–72. http://dx.doi.org/10.1677/joe.0.1360167.
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ABSTRACT We compared the reproducibility and repeatability of the acute adrenal response to low doses (90 and 500 ng/1·73 m2) of Synacthen (ACTH(1–24)) with that of the standard dose (250 μg/1·73 m2). We also examined the effect of basal cortisol levels on peak values achieved after stimulation with a low dose. ACTH(1–24) was given to six male volunteers: 90 ng/1·73 m2 twice at 90-min intervals on day 1, and 90 and 500 ng/1·73 m2 once on day 2 and 250 μg/1·73 m2 once on day 3. The rise in serum cortisol concentration with repeated low doses of ACTH was not attenuated (161 ± 49 (s.d.) nmol/l on initial vs 150 ± 41 nmol/l on repeat stimulation; P = 0·5) and this was reproducible (161 ± 49 nmol/l on day 1 vs 148 ± 15 nmol/l on day 2; P = 0·6). A dose of 500 ng ACTH(1–24)/1·73 m2 produced a maximal adrenal response in that the rise in serum cortisol concentration at 20 min was identical with that produced at the same time by the standard dose of 250 μg/1·73 m2. There was a strong positive correlation between the basal cortisol level and peak cortisol concentration after low-dose ACTH stimulation (r = 0·93, P < 0·001) but not between the basal cortisol level and the incremental rise (r= −0·1, P = 0·69). These results suggest that the cortisol response to low-dose ACTH stimulation is reproducible and not attenuated by repeat stimulation at 90-min intervals. The incremental rise in serum cortisol concentration after ACTH stimulation appears constant in these situations and is not influenced by the basal cortisol level. When there is concern that the standard dose may be excessive and mask subtle but important changes in adrenal function, the low dose (500 ng) of ACTH should be used. Journal of Endocrinology (1993) 136, 167–172
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Poore, KR, IR Young, BJ Canny, and GD Thorburn. "Studies on the role of ACTH in the regulation of adrenal responsiveness and the timing of parturition in the ovine fetus." Journal of Endocrinology 158, no. 2 (August 1, 1998): 161–71. http://dx.doi.org/10.1677/joe.0.1580161.
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A dramatic late-gestation increase in fetal plasma cortisol concentrations is critical for the timing of parturition in the sheep. This increase appears to depend upon an intact hypothalamo-pituitary unit and is characterised by increasing responsiveness of the fetal adrenal gland to ACTH. ACTH has been postulated as the critical determinant of the late-gestation cortisol increase; however, recent evidence has suggested that other factors, including the ACTH precursor, pro-opiomelanocortin, may also be involved. To further define the role of ACTH in determining the timing of parturition and the responsiveness of the fetal adrenal gland, intact (INT/ACTH) and hypophysectomised (HX/ACTH) fetuses received a continuous infusion of ACTH(1-24) from the time of surgery (approximately 115 days gestational age (GA)) at a rate we have previously shown to generate normal fetal cortisol concentrations and term parturition in HX fetuses. A third group of saline-infused intact fetuses (INT/SAL) served as the control group. Adrenal responsiveness was assessed by cortisol responses to ACTH(1-24) challenges at 120, 130 and 140 days GA. There were no differences between the three groups of fetuses in the timing of parturition, the late-gestation increase in cortisol concentrations or the size of the adrenal cortex. In both INT/SAL and INT/ACTH fetuses, there were significant increases in basal immunoreactive-ACTH concentrations with advancing GA, although no such increase was observed in HX/ACTH fetuses. The proportion of total ACTH immunoreactivity present in low molecular weight (LMW) forms in INT/ACTH fetuses was greater than that in INT/SAL fetuses, while the level of LMW ACTH in HX/ACTH fetuses was intermediate. Both ACTH(1-24)-infused groups of fetuses had dramatically enhanced adrenal responsiveness to ACTH(1-24) at all GAs tested when compared with INT/SAL fetuses and there was a correlation (in rank order) between the proportion of LMW ACTH immunoreactivity and adrenal responsiveness. From these observations it appears that there is a separate regulation of adrenal responsiveness from basal cortisol concentrations and that an increase in basal cortisol concentrations can occur in the absence of an increase in basal ACTH concentrations. Furthermore, an increase in adrenal responsiveness does not appear to predict the timing of parturition nor basal cortisol concentrations. Taken together with previous studies it appears that ACTH plays an essential role in maintaining the growth of the fetal adrenal and enhancing its responsiveness, but a late-gestation increase in ACTH concentrations is not required to regulate basal cortisol concentrations or the timing of parturition.
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Hanson, J. M., H. S. Kooistra, J. A. Mol, E. Teske, and B. P. Meij. "Plasma profiles of adrenocorticotropic hormone, cortisol, α-melanocyte-stimulating hormone, and growth hormone in dogs with pituitary-dependent hyperadrenocorticism before and after hypophysectomy." Journal of Endocrinology 190, no. 3 (September 2006): 601–9. http://dx.doi.org/10.1677/joe.1.06782.
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The 6-h plasma profiles of adrenocorticotropic hormone (ACTH), cortisol, α-melanocyte-stimulating hormone (α-MSH), and GH were studied in 17 dogs with pituitary-dependent hyperadrenocorticism (PDH) before and after hypophysectomy. The aim of the study was to investigate the relation between the hormone profile characteristics and recurrence of PDH after surgery. The hormones were secreted in a pulsatile fashion. The basal plasma cortisol concentration and area under the curve (AUC) for cortisol were significantly higher in the PDH cases than in eight controls. The characteristics of the plasma profiles of ACTH and α-MSH were not significantly different between the PDH cases and the controls. In the PDH cases, less GH was secreted in pulses than in the controls, but the difference was not significant. The basal plasma cortisol concentration, the AUC for ACTH and cortisol, and the pulse frequency of ACTH and cortisol decreased significantly after hypophysectomy for the group of PDH cases. The basal plasma concentrations of ACTH and α-MSH, the AUC for α-MSH, and the characteristics of the plasma GH profiles of the PDH cases remained unchanged after hypophysectomy. No pulses of α-MSH were observed after hypophysectomy. The co-occurrence between the ACTH and cortisol pulses decreased significantly with hypophysectomy. The postoperative pulse frequency of ACTH was the only characteristic with predictive value for the recurrence of PDH after hypophysectomy. The results of this study demonstrate that ACTH, cortisol, α-MSH, and GH are secreted in a pulsatile fashion in dogs with PDH. Hypophysectomy effectively reduces the secretion of ACTH and cortisol. The presence of ACTH pulses after hypophysectomy is a risk factor for the recurrence of hyperadrenocorticism.
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Norman, Laurie J., Stephen J. Lye, Mary E. Wlodek, and J. R. G. Challis. "Changes in pituitary responses to synthetic ovine corticotrophin releasing factor in fetal sheep." Canadian Journal of Physiology and Pharmacology 63, no. 11 (November 1, 1985): 1398–403. http://dx.doi.org/10.1139/y85-230.
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The rise in cortisol in fetal sheep during late pregnancy has been related to increased responsiveness of the adrenal to ACTH. Most reports have suggested that plasma ACTH concentrations rise coincident with or after the prepartum increase in cortisol. To reexamine the relationship of cortisol with basal immunoreactive ACTH (IR-ACTH) throughout the last 40 days of pregnancy and to determine changes in fetal pituitary responsiveness during this time, we measured basal and synthetic ovine corticotrophin-releasing factor (oCRF) (10 ng – 10 μg) induced rises in ACTH and cortisol in fetal sheep at days 110–115, 125–130, and 135–140 of pregnancy. The fetuses were catheterized on day 105–120 and entered spontaneous labour at > 140 days. Basal IR-ACTH (picograms per millilitre ± SEM) rose from 16.7 ± 2.9 pg/mL at day 110–115 to 34.8 ± 8.7 pg/mL at day 141–145. There was a significant effect of time on basal ACTH concentrations with a mean increase of approximately 5 pg ACTH per millilitre of plasma per 5-day sampling interval. Plasma cortisol changed gradually between day 110 and 125 of gestation and then more rapidly to term. At day 110–115 of gestation there was no significant change in plasma ACTH after 10 or 100 ng oCRF, but there was a significant increase in ACTH after 1 μg of oCRF. Plasma cortisol did not change after any CRF injection. The change in IR-ACTH after oCRF at day 125–130 of gestation was significantly greater than that at day 110–115. Plasma cortisol concentrations were elevated following 1- and 10-μg injections of oCRF. At day 135–140, significant rises in plasma ACTH were seen in response to 1 and 10 μg oCRF, but the response was less than that at day 125–130. In contrast, the response of plasma cortisol was significantly greater than at any of the other times in gestation. We conclude the following: (i) basal ACTH concentrations rise before the major prepartum increase in plasma cortisol; (ii) pituitary responsiveness to oCRF, measured as ACTH in plasma, increases between days 110–115 and 125–130 of gestation. The ACTH response decreased at day 135–140, perhaps reflecting negative feedback control by the rising basalcortisol concentrations; (iii) adrenal responsiveness increases progressively between days 110–115 and 135–140 of gestation, as reflected by changes in the plasmacortisol concentration in response to endogenously released ACTH.
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Matin, Sara, Masoud Ghanei Jahromi, Zohreh Karemizadeh, Sezaneh Haghpanah, Vincenzo De Sanctis, Ashraf Soliman, and Mehran Karimi. "THE FREQUENCY OF ADRENAL INSUFFICIENCY IN ADOLESCENTS AND YOUNG ADULTS WITH THALASSEMIA MAJOR VERSUS THALASSEMIA INTERMEDIA IN IRAN." Mediterranean Journal of Hematology and Infectious Diseases 7 (August 28, 2014): e2015005. http://dx.doi.org/10.4084/mjhid.2015.005.
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Background: Endocrine dysfunction is not uncommon complication in patients with transfusion dependent thalassemia and is thought to occur as a consequence of excessive iron overload. The main objective of this study is to determine the frequency of adrenal insufficiency in patients with thalassemia major and thalassemia intermediate. Methods: This cross-sectional study was done at the Shiraz University of Medical Sciences, Shiraz, Southern Iran, in 2013. One hundred and ninety patients were divided into two groups; thalassemia major(TM) and thalassemia intermediate (TI) groups. We measured 8 AM serum cortisol, ACTH and ferritin concentrations in all patients. Results: The mean age of the TM and TI group were 22.5±5.7 and 23.8±6 years, respectively. 90 patients (47.4%) were splenectomized, 34 (36.2%) with TM and 56 (58.2%) with TI (p : 0.001). The mean serum ferritin levels were 3056.5±2306 and 666.2±616.5 in TM and TI respectively (p: 0.001). Three patients with TM (1.6%) had low basal cortisol and ACTH levels. However their cortisol response to ACTH stimulation was normal. Conclusions: Low basal concentrations of cortisol and ACTH occurred in 1.6% of our adolescents young adult patients with TM suggesting a central defect of cortisol secretion at the basal state. However, cortisol response to standard – dose ACTH was normal in all patients with TM and TI.
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Misra, Madhusmita, Karen K. Miller, Kelly Kuo, Kathryn Griffin, Victoria Stewart, Emily Hunter, David B. Herzog, and Anne Klibanski. "Secretory dynamics of leptin in adolescent girls with anorexia nervosa and healthy adolescents." American Journal of Physiology-Endocrinology and Metabolism 289, no. 3 (September 2005): E373—E381. http://dx.doi.org/10.1152/ajpendo.00041.2005.
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Leptin, an adipocytokine that suppresses appetite and may regulate neuroendocrine pathways, is low in undernourished states like anorexia nervosa (AN). Although leptin exhibits pulsatility, secretory characteristics have not been well described in adolescents and in AN, and the contribution of hypoleptinemia to increased growth hormone (GH) and cortisol in AN has not been explored. We hypothesized that hypoleptinemia in AN reflects decreased basal and pulsatile secretion and may predict increased GH and cortisol levels. Sampling for leptin, GH, cortisol, and ghrelin was performed every 30 min (from 2000 to 0800) in 23 AN and 21 controls 12–18 yr old, and data were analyzed using Cluster and deconvolution methods. Estradiol, thyroid hormones, and body composition were measured. AN girls had lower pulsatile and total leptin secretion than controls ( P < 0.0001) subsequent to decreased burst mass ( P < 0.0001) and basal secretion ( P = 0.02). Nutritional markers predicted leptin characteristics. In a regression model including BMI, body fat, and ghrelin, leptin independently predicted GH burst interval and frequency. Valley leptin contributed to 56% of the variability in GH burst interval, and basal leptin and fasting ghrelin contributed to 42% of variability in burst frequency. Pulsatile leptin independently predicted urine free cortisol/creatinine (15% of variability). Valley leptin predicted cortisol half-life (22% of variability). Leptin predicted estradiol and thyroid hormone levels. In conclusion, hypoleptinemia in AN is subsequent to decreased basal and pulsatile secretion and nutritionally regulated. Leptin predicts GH and cortisol parameters and with ghrelin predicts GH burst frequency. Low leptin and high ghrelin may be dual stimuli for high GH concentrations in undernutrition.
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Norman, Laurie J., and John R. G. Challis. "Dexamethasone inhibits ovine corticotrophin-releasing factor (oCRF), arginine vasopressin (AVP), and oCRF + AVP stimulated release of ACTH during the last third of pregnancy in the sheep fetus." Canadian Journal of Physiology and Pharmacology 65, no. 6 (June 1, 1987): 1186–92. http://dx.doi.org/10.1139/y87-187.
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We examined the hypothesis that in fetal sheep during late pregnancy exogenous glucocorticoids might affect differentially the pituitary response, measured as changes in plasma ACTH concentrations, to the systemic administration of ovine corticotrophin-releasing factor (oCRF), arginine vasopressin (AVP), or oCRF + AVP. At d 113–116 of pregnancy, equimolar injections of oCRF and AVP given separately provoked similar significant increases in plasma ACTH; the change in ACTH over basal values was significantly greater than the sum of the two separate responses when AVP + oCRF were given together. Exogenous dexamethasone did not affect basal ACTH concentrations, but suppressed significantly the responses to oCRF, AVP, and oCRF + AVP. At d 126–130, there was a significant ACTH response to CRF alone and to AVP + oCRF, but not to AVP alone. The response during the first 30 min postinjection to oCRF was significantly less than that to AVP + oCRF. Plasma Cortisol rose after each peptide injection. Exogenous dexamethasone suppressed both basal and stimulated responses to each peptide. At the amounts injected, there was no significant ACTH or Cortisol response to oCRF, AVP, or oCRF + AVP at d 136–140, but dexamethasone suppressed basal ACTH and Cortisol concentrations at this time. We conclude that stimulated, but not basal, release of ACTH is subject to the negative feedback effect of exogenous glucocorticoid by d 113–116 of gestation in fetal sheep. Both basal and stimulated release of ACTH and Cortisol are suppressed after d 125. At the amount of exogenous dexamethasone given, oCRF, AVP, and oCRF + AVP-stimulated responses are affected similarly. Our results suggest different controls of basal and stimulated ACTH release from the pituitary at d 113–116 of gestation. Our findings would be consistent with the pituitary as a level of action for the negative feedback effect of corticosteroids on stimulated ACTH release throughout the last third of pregnancy in fetal sheep.
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Meczekalski, B., A. Tonetti, P. Monteleone, F. Bernardi, S. Luisi, M. Stomati, M. Luisi, F. Petraglia, and AR Genazzani. "Hypothalamic amenorrhea with normal body weight: ACTH, allopregnanolone and cortisol responses to corticotropin-releasing hormone test." European Journal of Endocrinology 142, no. 3 (March 1, 2000): 280–85. http://dx.doi.org/10.1530/eje.0.1420280.
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OBJECTIVE: Hypothalamic amenorrhea (HA) is a functional disorder caused by disturbances in gonadotropin-releasing hormone (GnRH) pulsatility. The mechanism by which stress alters GnRH release is not well known. Recently, the role of corticotropin-releasing hormone (CRH) and neurosteroids in the pathophysiology of HA has been considered. The aim of the present study was to explore further the role of the hypothalamic-pituitary-adrenal axis in HA. DESIGN: We included 8 patients (aged 23.16+/-1.72 years) suffering from hypothalamic stress-related amenorrhea with normal body weight and 8 age-matched healthy controls in the follicular phase of the menstrual cycle. METHODS: We measured basal serum levels of FSH, LH, and estradiol and evaluated ACTH, allopregnanolone and cortisol responses to CRH test in both HA patients and healthy women. RESULTS: Serum basal levels of FSH, LH, and estradiol as well as basal levels of allopregnanolone were significantly lower in HA patients than in controls (P<0.001) while basal ACTH and cortisol levels were significantly higher in amenorrheic patients with respect to controls (P<0.001). The response (area under the curve) of ACTH, allopregnanolone and cortisol to CRH was significantly lower in amenorrheic women compared with controls (P<0.001, P<0.05, P<0.05 respectively). CONCLUSIONS: In conclusion, women with HA, despite the high ACTH and cortisol levels and, therefore, hypothalamus-pituitary-adrenal axis hyperactivity, are characterized by low allopregnanolone basal levels, deriving from an impairment of both adrenal and ovarian synthesis. The blunted ACTH, allopregnanolone and cortisol responses to CRH indicate that, in hypothalamic amenorrhea, there is a reduced sensitivity and expression of CRH receptor. These results open new perspectives on the role of neurosteroids in the pathogenesis of hypothalamic amenorrhea.
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Zalewski, Maureen, Liliana J. Lengua, Stephanie F. Thompson, and Cara J. Kiff. "Income, cumulative risk, and longitudinal profiles of hypothalamic–pituitary–adrenal axis activity in preschool-age children." Development and Psychopathology 28, no. 2 (June 4, 2015): 341–53. http://dx.doi.org/10.1017/s0954579415000474.
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AbstractEnvironmental risk predicts disrupted basal cortisol levels in preschool children. However, little is known about the stability or variability of diurnal cortisol morning levels or slope patterns over time in young children. This study used latent profile analysis to identify patterns of the hypothalamic–pituitary–adrenal axis activity during the preschool period. Using a community sample (N = 306), this study measured income, cumulative risk, and children's diurnal cortisol (morning level and slope) four times across 2.5 years, starting when children were 36 months old. Latent profile analysis profiles indicated that there were predominantly stable patterns of diurnal cortisol level and slope over time and that these patterns were predicted by income and cumulative risk. In addition, there were curvilinear relations of income and cumulative risk to profiles of low morning cortisol level and flattened diurnal slope across time, suggesting that both lower and higher levels of income and cumulative risk were associated with a stress-sensitive physiological system. Overall, this study provides initial evidence for the role of environmental risk in predicting lower, flattened basal cortisol patterns that remain stable over time.
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Keenan, Daniel M., Ferdinand Roelfsema, and Johannes D. Veldhuis. "Endogenous ACTH concentration-dependent drive of pulsatile cortisol secretion in the human." American Journal of Physiology-Endocrinology and Metabolism 287, no. 4 (October 2004): E652—E661. http://dx.doi.org/10.1152/ajpendo.00167.2004.
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According to current regulatory concepts, pulsatile ACTH concentrations (CON) stimulate time-lagged cortisol secretion rates (SEC) via an implicit CON-SEC dose-response relationship. The present analyses reconstruct nonlinear properties of this in vivo agonist-response interface noninvasively in order to investigate pulse-by-pulse coupling consistency and to obviate the need to infuse isotopes or exogenous effectors, which may disrupt pathway interactions. This approach required an ensemble strategy of 1) measuring ACTH and cortisol CON in plasma sampled every 10 min for 24 h in 32 healthy adults, and 2) estimating simultaneously a) variable-waveform ACTH and cortisol SEC bursts superimposed upon fixed basal SEC; b) biexponential kinetics of ACTH and cortisol disappearance; c) nonequilibrium exchange of cortisol among free and cortisol-binding globulin (CBG)- and albumin-bound moieties; d) two SEC-burst shapes demarcated by a statistically defined day/night boundary; e) feedforward efficacy, potency, and sensitivity; and f) stochastic variability in feedforward measures over time. Thereby, we estimate 1) ACTH SEC (μg·l−1·day−1) of 0.27 ± 0.04 basal and 0.87 ± 0.07 pulsatile (means ± SE); 2) cortisol SEC (μmol·l−1·day−1) of 0.10 ± 0.01 basal and 3.5 ± 0.20 pulsatile; 3) free cortisol half-lives (min) of 1.8 ± 0.20 (diffusion/advection) and 4.1 ± 0.30 (elimination) and a half-life of total cortisol of 49 ± 2.4 and of ACTH of 20 ± 1.3; 4) ACTH potency (EC50, ng/l) of 26 ± 2.4, efficacy (nmol·l−1·min−1) 10 ± 1.8, and sensitivity (slope units) 0.65 ± 0.09; 5) night/day augmentation of ACTH and cortisol SEC-burst mass by 2.1- and 1.7-fold (median); 6) abbreviation of the modal time to maximal ACTH and cortisol SEC rates by 4.4- and 4.3-fold, respectively, after a change point clock time of 0205 (median); 7) in vivo percentage distribution of cortisol as 6% free, 14% albumin bound, and 80% CBG bound with an absolute free cortisol CON (nmol/l) 11.5 ± 0.54; and 8) significant (mean CV) stochastic variability in feedforward efficacy (140%), potency (38%), and sensitivity (56%) within the succession of paired ACTH/cortisol pulses of any given subject. In conclusion, the present composite formulation illustrates a platform for dissecting mechanisms of in vivo regulation of effector-response properties noninvasively in the corticotropic axis of the uninfused individual.
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Meewisse, Marie-Louise, Johannes B. Reitsma, Giel-Jan De Vries, Berthold P. R. Gersons, and Miranda Olff. "Cortisol and post-traumatic stress disorder in adults." British Journal of Psychiatry 191, no. 5 (November 2007): 387–92. http://dx.doi.org/10.1192/bjp.bp.106.024877.
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BackgroundPost-traumatic stress disorder (PTSD) has inconsistently been associated with lower levels of cortisol.AimsTo compare basal cortisol levels in adults with current PTSD and in people without psychiatric disorder.MethodSystematic review and meta-analysis. Standardised mean differences (SMD) in basal cortisol levels were calculated and random-effects models using inverse variance weighting were applied.ResultsAcross 37 studies, 828 people with PTSD and 800 controls did not differ in cortisol levels (pooled SMD = −0.12, 95% C1= −0.32 to 0.080). Subgroup analyses revealed that studies assessing plasma or serum showed significantly lower levels in people with PTSD than in controls not exposed to trauma. Lower levels were also found in people with PTSD when females were included, in studies on physical or sexual abuse, and in afternoon samples.ConclusionsLow cortisol levels in PTSD are only found under certain conditions. Future research should elucidate whether low cortisol is related to gender or abuse and depends on the measurement methods used.
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Haim, S. Ben, L. Kahana, Y. Bentur, M. Sheinfeld, L. Levy, A. Laor, and S. Bursztein. "Effect of metoclopramide-A dopaminergic blocker and endogenous cortisol on TSH secretion in critically ill men." Acta Endocrinologica 109, no. 1 (May 1985): 70–75. http://dx.doi.org/10.1530/acta.0.1090070.
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Abstract. In 17 critically ill men, low levels of FT4, TT4, TT3 and elevated levels of rT3 and cortisol were found. In spite of the low levels of circulating thyroid hormones, TSH levels of the critically ill men were significantly lower than those of the control group, with no correlations to the high cortisol levels. After iv injection of metoclopramide (MCP), a dopamine (DA) receptor blocker, the TSH and prolactin (Prl) increments in the critically ill patients were significantly lower than in the controls. No correlation was observed between basal cortisol levels and integrated TSH response to MCP. It is suggested that increased DA tone or high cortisol levels are not responsible for the lower basal TSH levels and for the blunted TSH or Prl responses to MCP in the critically ill. High levels of cortisol may be responsible for the altered TT4 peripheral metabolism to TT3 and rT3 in these patients.
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Cuff, TL, RJ Williams, CM Deaton, NC Smith, BD Davies, MCG Davies-Morel, DJ Marlin, and PA Harris. "Changes in plasma cortisol and ascorbic acid in horses with and without recurrent airway obstruction upon exercise and ascorbic acid supplementation." Equine and Comparative Exercise Physiology 2, no. 2 (May 2005): 105–12. http://dx.doi.org/10.1079/ecp200548.
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AbstractDiminished basal plasma cortisol concentrations and a blunted cortisol response to exercise have been observed in human asthmatics. In horses with recurrent airway obstruction (RAO), plasma concentrations of cortisol at rest are not significantly different from those of healthy horses, but the effect of exercise on endogenous cortisol concentrations has not been described. Ascorbic acid is a non-enzymatic antioxidant with proposed immune-modulating properties. In man, supplementation with ascorbic acid has been shown to attenuate the exercise-induced increase in plasma cortisol following prolonged, submaximal exercise. The relationship between cortisol and ascorbic acid has not previously been investigated in the horse. In a blinded cross-over design, five horses with RAO and six healthy non-RAO controls performed a standard exercise test following 4 weeks of supplementation with either an antioxidant (providing 10 mg ascorbic acid kg−1 day−1) or a placebo (<1 mg ascorbic acid kg−1 day−1). Venous blood samples were obtained 1 h prior to exercise and at 0, 15, 60 min and 24 h thereafter. Exercise resulted in a significant increase in plasma cortisol concentrations in both groups of horses (P<0.05). Basal and post-exercise concentrations of plasma cortisol in the RAO group (136±16 and 210±16 μmol l−1, respectively) were not significantly different from those in the non-RAO group (129±43 and 218±30 μmol l−1, respectively). Antioxidant supplementation increased basal and post-exercise concentrations of plasma ascorbic acid in RAO and non-RAO horses (P<0.05) but had no effect on plasma cortisol concentration in either group, before or after exercise (RAO: rest 157±27 μmol l−1, post-exercise 222±21 μmol l−1; non-RAO: rest 140±11 μmol l−1, post-exercise 227±35 μmol l−1). In conclusion, RAO-affected horses in remission demonstrate the same cortisol response to exercise as healthy controls. Antioxidant supplementation had no impact on post-exercise concentrations of plasma cortisol in either healthy or RAO-affected horses in remission.
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Fletcher, Andrew J. W., David S. Gardner, C. Mark B. Edwards, Abigail L. Fowden, and Dino A. Giussani. "Development of the ovine fetal cardiovascular defense to hypoxemia towards full term." American Journal of Physiology-Heart and Circulatory Physiology 291, no. 6 (December 2006): H3023—H3034. http://dx.doi.org/10.1152/ajpheart.00504.2006.
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We tested the hypothesis that fetal cardiovascular responses to hypoxemia change close to full term in relation to the prepartum increase in fetal basal cortisol and investigated, in vivo, the neural and endocrine mechanisms underlying these changes. Fetal heart rate and peripheral hemodynamic responses to 1 h of hypoxemia were studied in 25 chronically instrumented sheep within three narrow gestational age ranges: 125–130 ( n = 13), 135–140 ( n = 6), and >140 ( n = 6) days (full term ∼145 days). Chemoreflex function and plasma concentrations of vasoconstrictor hormones were measured. Reductions in fetal arterial Po2 during hypoxemia were similar at all ages. At 125–130 days, hypoxemia elicited transient bradycardia, femoral vasoconstriction, and increases in plasma concentrations of catecholamines, neuropeptide Y (NPY), AVP, ACTH, and cortisol. Close to full term, in association with the prepartum increase in fetal basal cortisol, there was a developmental increase in the magnitude and persistence of fetal bradycardia and in the magnitude of the femoral constrictor response to hypoxemia. The mechanisms mediating these changes close to full term included increases in the gain of chemoreflex function and in the magnitudes of the fetal NPY and AVP responses to hypoxemia. Data combined irrespective of gestational age revealed significant correlations between fetal basal cortisol and fetal bradycardia, femoral resistance, chemoreflex function, and plasma AVP concentrations. The data show that the fetal cardiovascular defense to hypoxemia changes in pattern and magnitude just before full term because of alterations in the gain of the neural and endocrine mechanisms mediating them, in parallel with the prepartum increase in fetal basal cortisol.