Hyperinsulinaemia, dyslipidaemia and exaggerated adrenal androgen response to adrenocorticotropin in male smokers.
Insulin resistance and dyslipidaemia associated with smoking may result from increased secretion of anti-insulin hormones. We compared the pituitary-adrenocortical function using oral glucose tolerance, dexamethasone suppression and ACTH stimulation tests in smoking (n = 22) and non-smoking (n = 22) healthy males matched for age, body mass index, and waist-to-hip ratio. Smokers had lower HDL-cholesterol (p < 0.02), and higher triglyceride (p < 0.001), basal cortisol (p < 0.05), insulin (p < 0.05), and C-peptide (p < 0.02) levels, and a higher response of insulin and C-peptide to oral glucose (p < 0.005) than non-smokers, while the ACTH, cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone, and androstenedione responses to oral glucose were similar in both groups. No differences were found in the response of cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone, and androstenedione to dexamethasone. In contrast, the response of 17-hydroxyprogesterone (p = 0.04), dehydroepiandrosterone (p = 0.007), and androstenedione (p = 0.001) to ACTH was higher in smokers than non-smokers, while the increase in cortisol was of marginal significance (p = 0.07). In multiple regression analyses the dehydroepiandrosterone response to ACTH was a significant determinant of insulin, C-peptide, and triglyceride levels independent of physical activity, waist-to-hip ratio and HDL-cholesterol. Thus, smoking inhibits the adrenal 21-hydroxylase resulting in an increase in the production of adrenal androgens, which might contribute to the insulin resistance and dyslipidaemia in smokers.
Hautanen
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A
Department of Clinical Chemistry, University of Helsinki, Finland.
Adlercreutz
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H
D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism; D000328:Adult; D000428:Alcohol Drinking; D000735:Androstenedione / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D002096:C-Peptide / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D003687:Dehydroepiandrosterone / Q000097:blood; D003907:Dexamethasone / Q000627:therapeutic use; D005947:Glucose / Q000494:pharmacology; D005951:Glucose Tolerance Test; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D006908:Hydroxyprogesterones / Q000097:blood; D006946:Hyperinsulinism; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010913:Pituitary-Adrenal System / Q000187:drug effects / Q000502:physiology / Q000503:physiopathology*; D012016:Reference Values; D012907:Smoking / Q000097:blood* / Q000503:physiopathology*; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D002096:C-Peptide; D008076:Cholesterol, HDL; D006908:Hydroxyprogesterones; D007328:Insulin; D014280:Triglycerides; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019326:17-alpha-Hydroxyprogesterone; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D005947:Glucose; D006854:Hydrocortisone