title: Dehydroepiandrosterone in relation to other adrenal hormones during an acute inflammatory stressful disease state compared with chronic inflammatory disease: role of interleukin-6 and tumour necrosis factor.
abstract: OBJECTIVE
  Serum levels of dehydroepiandrosterone (DHEA) and DHEA sulphate (DHEAS) are low in chronic inflammatory diseases, although the reasons are unexplained. Furthermore, the behaviour of serum levels of these hormones during an acute inflammatory stressful disease state is not well known.
  
  
  METHODS
  In this study in patients with an acute inflammatory stressful disease state (13 patients undergoing cardiothoracic surgery) and patients with chronic inflammation (61 patients with inflammatory bowel diseases (IBD)) vs. 120 controls, we aimed to investigate adrenal hormone shifts looking at serum levels of DHEA in relation to other adrenal hormones. Furthermore, we tested the predictive role of serum tumour necrosis factor (TNF) and interleukin-6 (IL-6) for a change of serum levels of DHEA in relation to other adrenal hormones.
  
  
  RESULTS
  The molar ratio of serum levels of DHEA/androstenedione (ASD) was increased in patients with an acute inflammatory stressful disease state and was decreased in patients with chronic inflammation. The molar ratio of serum levels of DHEAS/DHEA was reduced during an acute inflammatory stressful disease state and was increased in patients with chronic inflammation. A multiple linear regression analysis revealed that elevated serum levels of TNF were associated with a high ratio of serum levels of DHEA/ASD in all groups (for IL-6 in patients with an acute inflammatory stressful disease state only), and, similarly, elevated serum levels of TNF were associated with a high ratio of serum levels of DHEAS/DHEA only in IBD (for IL-6 only in healthy subjects).
  
  
  CONCLUSIONS
  This study indicates that changes of serum levels of DHEA in relation to serum levels of other adrenal hormones are completely different in patients with an acute inflammatory stressful disease state compared with patients with chronic inflammation. The decrease of serum levels of DHEAS and DHEA is typical for chronic inflammation and TNF and IL-6 play a predictive role for these changes.
authors.affiliation: Department of Internal Medicine I, University Hospital Regensburg, 93042 Regensburg, Germany. rainer.straub@klinik.uni-regensburg.de
authors.forename: Rainer H
authors.initials: RH
authors.lastname: Straub
authors.forename: Karin
authors.initials: K
authors.lastname: Lehle
authors.forename: Hans
authors.initials: H
authors.lastname: Herfarth
authors.forename: Markus
authors.initials: M
authors.lastname: Weber
authors.forename: Werner
authors.initials: W
authors.lastname: Falk
authors.forename: Jurgen
authors.initials: J
authors.lastname: Preuner
authors.forename: Jurgen
authors.initials: J
authors.lastname: Scholmerich
mesh_terms: D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000097:blood*; D000328:Adult; D000735:Androstenedione / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000523:psychology; D002908:Chronic Disease; D003687:Dehydroepiandrosterone / Q000097:blood*; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood*; D015212:Inflammatory Bowel Diseases / Q000097:blood / Q000523:psychology; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D000305:Adrenal Cortex Hormones; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D000735:Androstenedione; D003687:Dehydroepiandrosterone; D019314:Dehydroepiandrosterone Sulfate