title: Determinants of adrenal androgen hypofunction in premenopausal females with rheumatoid arthritis.
abstract: The aim of our study was to investigate adrenocortical function in the context of disease activity and inflammatory status in premenopausal RA females. Adrenal glucocorticoid and androgen responses to the 1 microg ACTH 1-24 test were investigated in 23 premenopausal RA and in 15 age- and BMI-matched healthy females. Twelve RA patients were on low-dose prednisone (<8.5 mg/day). Patients with DAS28>3.2 had lower (p<0.05) total plasma cortisol, 17-hydroxyprogesterone, dehydroepiandrosterone and androstenedione responses in the ACTH test compared to healthy controls. Patients with DAS28>3.2 had lower (p<0.05) dehydroepiandrosterone response in the ACTH test compared to patients with DAS28</=3.2. C-reactive protein (CRP), DAS28, and interleukin (IL)-6 negatively correlated with androstenedione response to ACTH 1-24. Responses of all measured adrenal steroids were lower (p<0.05) in patients on low-dose glucocorticoids compared to healthy controls. RA patients not treated with glucocorticoids had lower total cortisol response (p=0.038) but did not differ in free plasma cortisol in the ACTH test. The results indicate an association of increased disease activity with a decrease in adrenal androgen production in RA and normal cortisol bioavailability in patients not treated with glucocorticoids.
authors.affiliation: Center for Molecular Medicine, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovak Republic. richard.imrich@savba.sk.
authors.forename: R
authors.initials: R
authors.lastname: Imrich
authors.forename: M
authors.initials: M
authors.lastname: Vlcek
authors.forename: J
authors.initials: J
authors.lastname: Kerlik
authors.forename: M
authors.initials: M
authors.lastname: Vogeser
authors.forename: F
authors.initials: F
authors.lastname: Kirchhoff
authors.forename: A
authors.initials: A
authors.lastname: Penesova
authors.forename: Z
authors.initials: Z
authors.lastname: Radikova
authors.forename: J
authors.initials: J
authors.lastname: Lukac
authors.forename: J
authors.initials: J
authors.lastname: Rovensky
mesh_terms: D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1 / Q000378:metabolism; D019326:17-alpha-Hydroxyprogesterone / Q000097:blood*; D000273:Adipose Tissue / Q000378:metabolism; D000302:Adrenal Cortex / Q000503:physiopathology*; D000305:Adrenal Cortex Hormones / Q000097:blood*; D000324:Adrenocorticotropic Hormone; D000328:Adult; D000728:Androgens / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000503:physiopathology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017697:Premenopause / Q000097:blood; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D000728:Androgens; D019326:17-alpha-Hydroxyprogesterone; D000324:Adrenocorticotropic Hormone; D043205:11-beta-Hydroxysteroid Dehydrogenase Type 1