Difference In Cortisol Excretion Research Articles

Susceptibility to Adrenal Crisis Is Associated With Differences in Cortisol Excretion in Patients With Secondary Adrenal Insufficiency.

ObjectiveTo compare cortisol pharmacokinetics and pharmacodynamics mapped through several glucocorticoid sensitive pathways in patients on hydrocortisone substitution with or without an adrenal crisis.DesignA post-hoc analysis of a previously conducted randomized controlled trial in patients with secondary adrenal insufficiency examining the effects of 2 weight-adjusted hydrocortisone doses.MethodsComparisons were primarily made on a hydrocortisone dose of 0.2-0.3 mg/kg/day for plasma cortisol and cortisone, 24-hour urinary steroid profile, the glucocorticoid sensitive tryptophan-kynurenine pathway, the renin-angiotensin-aldosterone system and aspects of quality of life. Variables of interest were also analyzed on the hydrocortisone dose of 0.4-0.6 mg/kg/day.ResultsOut of 52 patients, 9 (17%) experienced at least one adrenal crisis (AC+ group) and 43 did not develop an adrenal crisis (AC- group) during an observation period of 10 years. 24-hour urinary excretion of cortisol and cortisone were lower in the AC+ group (0.05 [IQR 0.03; 0.05] vs. 0.09 [0.05; 0.12] µmol/24h, P=0.01and 0.13 [0.10; 0.23] vs. 0.24 [0.19; 0.38] µmol/24h, P=0.04, respectively). No differences in pharmacokinetics of cortisol were observed. Kynurenine concentrations were higher in the AC+ group (2.64 [2.43; 3.28] vs. 2.23 [1.82; 2.38] µmol/L, P=0.03) as was general fatigue (Z-scores 1.02 [-0.11; 1.42] vs. -0.16 [- 0.80; 0.28], P=0.04). On the higher hydrocortisone dose urinary excretion of cortisol and cortisone was still significantly lower between the AC- and AC + group. The differences in glucocorticoid sensitive variables disappeared.ConclusionPatients susceptible to an adrenal crisis demonstrated differences in cortisol and cortisone excretion as well as in pharmacodynamics when compared to patients who did not experience an adrenal crisis, suggesting a biological predisposition in certain patients for the development of an adrenal crisis.

Social and reproductive factors affecting cortisol levels in wild female golden lion tamarins (Leontopithecus rosalia)

The steroid hormone cortisol has been associated with different levels of "stress" as well as different reproductive conditions in many primates. In callitrichids, cortisol has more often been reflective of female reproductive status than of chronic stress. In this study, we addressed the hypothesis that wild golden lion tamarin (Leontopithecus rosalia) females, whose social structure is characterized by low aggression and high social support, would not show rank ("stress")-related differences in glucocorticoids but would show reproductive changes. We collected 710 fecal samples from 22 adult females in Poço das Antas Reserve, Brazil, and nearby reintroduction areas, and assayed them for cortisol. Differences in cortisol levels were found between different reproductive conditions. Females in the first trimester of pregnancy had lower cortisol levels than nonpregnant females, although we did not differentiate between basal and ovulating levels in nonpregnant females. Cortisol rose in the third trimester of pregnancy. Primiparous females had a higher rise in the third trimester than multiparous females. No differences in cortisol levels were found among dominant females, ovulatory subordinate females, or anovulatory subordinate females. These results are similar to those obtained in other studies of callitrichid females. The lack of differences in cortisol excretion between dominants and subordinates is likely due to the low levels of overt aggression and the high level of social support available to subordinate females.

Sex differences in cortisol excretion during anticipation of a psychological stressor: possible support for the tend–and–befriend hypothesis

AbstractThe present experiment tested the hypothesis that differential neuroendocrine elicitation is prompted by subjects' cognitive expectations of an anticipated stressor. Subjects making a ‘threat appraisal’ of an academic examination were predicted to have increased hypothalamic–pituitary–adrenal (HPA) activation, while activation was expected to be unchanged in subjects making a ‘challenge appraisal.’ Self‐reported anxiety in relation to these variables was also examined. HPA activation was assessed by urinary cortisol at baseline (at least 1 week before the examination) and at pre‐test (immediately before the examination). Contrary to the hypothesis, there was an unexpected sex × time interaction that was particularly robust in subjects making a challenge appraisal. Males in the challenge appraisal group had a significant increase in cortisol excretion from baseline to pre‐test, with greater reported anxiety than the threat appraisal group. In contrast, females had a decrease in cortisol excretion that was significant for only the challenge appraisal group, although reported anxiety between the challenge and threat groups was not different. Results may support the recent proposition that the female stress response has evolved differently than that of males, or they may reflect sex differences in production of corticosteroid‐binding globulin. Copyright © 2001 John Wiley & Sons, Ltd.

Inhaled Steroids and Adrenal Function in Asthmatic Children

Inhaled steroids are potent anti-inflammatory agents used in the treatment of asthma. One of the most important side-effects of their use is their capacity to suppress the hypothalamic-pituitary-adrenal (HPA) axis. Our study evaluated whether inhaled beclomethasone dipropionate (BDP) for a long period (1 month) at a dose >600 μg/mq/day could suppress the HPA axis and cortisol excretion. We analyzed the 24-hour urinary free cortisol excretion in 14 children (7 boys and 7 girls) receiving inhaled BDP for 1 month, at the beginning of the study, after 14 and 28 days of therapy, and 1 month after its stoppage. We found no significant difference in cortisol excretion during the study time. Our population was also divided into two groups: group A receiving a dose of inhaled BDP ≤800 μg/mq/day and group B receiving a dose >800 μg/mq/day. No significant difference in cortisol excretion was found between group A and group B. The results of our study confirm that inhaled BDP, when used at a minimal dose of 600 μg/mq/day for a long period, does not suppress the HPA axis.