Alzheimer's disease: pathophysiological implications of measurement of plasma cortisol, plasma dehydroepiandrosterone sulfate, and lymphocytic corticosteroid receptors.
Alzheimer's disease is often characterized by an increase in plasma cortisol without clinical evidence of hypercorticism. Twenty-three consecutive patients with Alzheimer's disease and 23 age- and sex-matched healthy controls were studied by measuring plasma cortisol and dehydroepiandrosterone sulfate (DHEAS) (by enzyme immunoassay), the number of type I and type II corticosteroid receptors in mononuclear leukocytes (by radio-receptor-assay), and the lymphocyte subpopulations (by cytofluorimetry). Results are expressed in terms of median and range. In Alzheimer's disease, plasma cortisol was higher than in controls (median 0.74, range 0.47-1.21 vs 0.47, 0.36-0.77 mmol/L; p < 0.001). Plasma DHEAS, the DHEAS/cortisol ratio, and the number of type II corticosteroid receptors were significantly lower in AD than in controls (DHEAS: median 1.81, range 0.21-3.69 vs 3.51, 1.35-9.07 micromol/L; DHEAS/ cortisol: 2.04, range 0.3-5.8 vs 6.8, range 2.7-24 and type II receptors: 1219, 1000-2700 vs 1950, 1035- 2750 receptors per cell; p < 0.001). No correlation was found between the hormonal parameters, age, and mini-mental test score. These data support the hypothesis of a dysregulation of the adrenal pituitary axis in Alzheimer's disease, which is probably the consequence of damage to target tissues by corticosteroids.
Armanini
Decio
D
Department of Medical and Surgical Sciences-Endocrinology, University of Padua, Via Ospedale 105, 35100 Padua, Italy. decio.armanini@unipd.it
Vecchio
Franco
F
Basso
Alfonso
A
Milone
Francesco Ferro
FF
Simoncini
Maria
M
Fiore
Cristina
C
Mattarello
Mee Joung
MJ
Sartorato
Paola
P
Karbowiak
Isabella
I
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood* / Q000503:physiopathology; D016022:Case-Control Studies; D003687:Dehydroepiandrosterone / Q000097:blood*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007118:Immunoassay; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011869:Radioligand Assay; D011987:Receptors, Steroid / Q000378:metabolism*
D011987:Receptors, Steroid; D003687:Dehydroepiandrosterone; D006854:Hydrocortisone