title: Relationships between cortisol, dehydroepiandrosterone sulphate and insulin-like growth factor-I system in dementia.
abstract: Changes in the hypothalamus-pituitary-adrenal axis (HPAA) function, entailing elevated cortisol circulating titres, occur in aging and in some neurological conditions, such as Alzheimer's disease (AD). Excess cortisol has neurotoxic effects which affect hippocampal neurones. Dehydroepiandrosterone sulphate (DHEAS) has an antiglucocorticoid activity and neuroprotective effects, but its levels decrease with aging. Glucocorticoids influence the production of insulin-like growth factor-I (IGF-I) and modify its systemic and neurotrophic biological activity by inducing changes in IGF-binding proteins (IGFBPs). We looked for relationships between cortisol, DHEAS levels, and IGF-I - IGFBPs system in AD. Cortisol, DHEAS and GH levels at 02:00, 08:00, 14:00, 20:00 h, basal IGF-I, IGFBP-1 and IGFBP-3 levels were determined by RIAs or IRMA in 25 AD patients, aged 58-89 yr, and in 12 age-matched healthy controls. AD subjects had higher cortisol, lower DHEAS levels and increased cortisol/DHEAS ratio (C/Dr) than controls. In AD cases, total IGF-I, IGFBP-3, and IGF-I/IGFBP ratios were significantly lowered, while IGFBP-1 levels were significantly higher than in controls. We found a significant inverse correlation between IGF-I and IGFBP-3 levels vs C/Dr, and between both IGF-I/IGFBPs ratios vs mean cortisol levels. IGFBP-3 correlated directly with DHEAS. Cortisol was directly and IGF-I inversely correlated with cognitive impairment. In AD patients we found that alterations in HPAA function and elevated C/Dr are related to lowered total and free IGF-I levels. These findings and their relationship to cognitive impairment suggest that changes in hormonal set-up might influence the clinical presentation of the disease.
authors: Department of Endocrinological and Metabolic Sciences, Clinical Neurophysiology Service, University of Genova, Italy. disem@unige.it
authors: G
authors: G
authors: Murialdo
authors: A
authors: A
authors: Barreca
authors: F
authors: F
authors: Nobili
authors: A
authors: A
authors: Rollero
authors: G
authors: G
authors: Timossi
authors: M V
authors: MV
authors: Gianelli
authors: F
authors: F
authors: Copello
authors: G
authors: G
authors: Rodriguez
authors: A
authors: A
authors: Polleri
mesh_terms: D000311:Adrenal Glands / Q000503:physiopathology; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood* / Q000503:physiopathology; D002940:Circadian Rhythm; D003071:Cognition; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007031:Hypothalamus / Q000503:physiopathology; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000503:physiopathology
chemical_list: D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D019314:Dehydroepiandrosterone Sulfate; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone