title: 11beta-hydroxysteroid dehydrogenase activity in acromegalic patients with normal or impaired carbohydrate metabolism.
abstract: The 11beta-hydroxysteroid dehydrogenase isoenzymes (11beta-HSD) catalyse the interconversion of cortisol (F) and cortisone (E). Earlier studies demonstrated that growth hormone (GH) and insulin resistance may exert opposite effects on the conversion of E to F by 11beta-HSD type 1. Therefore, in the present study we determined F and E concentrations in 562 plasma samples obtained from acromegalic patients during an active phase (76 patients) and after cure of the disease (68 patients). In addition, we examined whether type 2 diabetes mellitus or impaired glucose tolerance, which are frequently associated with active acromegaly could influence plasma F and E levels in these patients. We found that plasma F concentrations were similar in patients with active acromegaly and in those who were cured with pituitary surgery, irradiation and/or medical therapy (mean+/-S.E., 12.4+/-0.3 and 12.7+/-0.4 microg/dl, respectively). However, plasma E levels were significantly higher in patients with active compared to those with cured acromegaly (2.8+/-0.1 and 2.2+/-0.1 microg/dl, respectively; p<0.001), resulting in a lower F/E ratio in patients with active disease (4.6+/-0.1 vs. 5.9+/-0.2 in the cured group of patients; p<0.001). When the effect of altered carbohydrate homeostasis on plasma F and E was analysed, the results indicated significantly lower plasma E levels and higher F/E ratios in active acromegalic patients with type 2 diabetes mellitus or impaired glucose tolerance compared to those with normal carbohydrate metabolism (E, 2.5+/-0.1 and 3.0+/-0.1 microg/dl, respectively; F/E, 5.1+/-0.2 and 4.4+/-0.1; p<0.001), whereas plasma F concentrations were similar in these two groups (12.1+/-0.4 and 12.6+/-0.3 microg/dl, respectively). These findings indicate that disease activity exerts a significant impact on 11beta-HSD in acromegalic patients, which is further modified with altered carbohydrate homeostasis, frequently present in patients with active disease.
authors.affiliation: 2nd Department of Medicine, Semmelweis University, Budapest, Hungary.
authors.forename: Agnes
authors.initials: A
authors.lastname: Mondok
authors.forename: Ibolya
authors.initials: I
authors.lastname: Varga
authors.forename: Edit
authors.initials: E
authors.lastname: Glaz
authors.forename: Nikolette
authors.initials: N
authors.lastname: Szucs
authors.forename: Miklós
authors.initials: M
authors.lastname: Tóth
authors.forename: Attila
authors.initials: A
authors.lastname: Patocs
authors.forename: Gabriella
authors.initials: G
authors.lastname: Beko
authors.forename: Karoly
authors.initials: K
authors.lastname: Racz
mesh_terms: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1 / Q000378:metabolism*; D000172:Acromegaly / Q000097:blood / Q000150:complications* / Q000201:enzymology* / Q000378:metabolism; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050260:Carbohydrate Metabolism; D003348:Cortisone / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D005260:Female; D018149:Glucose Intolerance / Q000150:complications / Q000378:metabolism; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1; D003348:Cortisone; D006854:Hydrocortisone