Ghrelin and the GH secretagogue receptors (GHS-R) are expressed in several peripheral tissues, including adrenal glands. The hypothalamic-pituitaryadrenal axis of patients with 21-hydroxylase deficiency (21OH-D) can be only partially balanced after treatment. This could interfere with the ghrelin/GH/ IGF1 axis, contributing to the poor auxological outcome of these patients. We studied the possible short term effects of corticosteroids administration on the ghrelin/GH/IGF1 and the CRF/ACTH/adrenal axes in CAH patients, examining thirty-seven 21OH-D patients (17 M, 20 F; 13 SW, 11 SV, 13 NC forms). The patients avoided for one day the evening doses of glico- and mineralo-corticoids; the morning after, two blood samples were drawn (8:00 a. m. and 10:30-11:00 a.m.), the first immediately before and the second after an evening+morning dose of therapy. In both samples glycaemia, ghrelin, GH, IGF1, CRF, ACTH, cortisol, D4-androstenedione (D4-A), 17OH-progesterone (17OHP), insulin, plasma renin activity (PRA) were assayed. As expected, the pre/post treatment evaluation showed a statistically significant rise in cortisol and a fall in ACTH, 17OHP and D4-A levels; the same pattern of cortisol was shown by ghrelin, glycaemia and PRA, while IGF1 levels decreased; no significant differences were found for Insulin, CRF and GH levels. Analysis in a multiple regression model, showed that plasma ghrelin changes were mainly due to changes of D4-A (pre and post therapy; F=6.465, P=0.0136) and at a minor extent to changes of GH (only post therapy; F=4.447, P=0.044). Ghrelin showed to be influenced from acute corticosteroid therapy as were the other hormones involved in the hypothalamic-pituitary-adrenal and GH/IGF1 axes; interestingly, a similar ghrelin/D4-A negative correlation was found from Gambineri et al. in a group of obese women with polycystic ovary syndrome; a potential negative effect on ghrelin levels can be hypothesized for the CAH patients whose androgens could not be well controlled with treatment.
Relationships between ghrelin, hypothalamic-pituitary-adrenal- and GH/IGF1 axes in patients treated for congenital adrenal hyperplasia / A. Balsamo;S. Forti;M. Bal;M. Gennari;R. Di Iasio;S. Gualandi;D. Elleri;A. Cicognani. - In: HORMONE RESEARCH. - ISSN 0301-0163. - STAMPA. - 64:(2005), pp. 340-340. (Intervento presentato al convegno European Society for Paediatric Endocrinology (ESPE) / Lawson Wilkins Pediatric Endocrine Society (LWPES) 7th Joint Meeting in collaboration with APEG, APPES, JSPE and SLEP tenutosi a Lyon nel September 2005).
Relationships between ghrelin, hypothalamic-pituitary-adrenal- and GH/IGF1 axes in patients treated for congenital adrenal hyperplasia
BALSAMO, ANTONIO;FORTI, SARA;BAL, MILVA ORQUIDEA;GENNARI, MONIA;GUALANDI, STEFANO;ELLERI, DANIELA;CICOGNANI, ALESSANDRO
2005
Abstract
Ghrelin and the GH secretagogue receptors (GHS-R) are expressed in several peripheral tissues, including adrenal glands. The hypothalamic-pituitaryadrenal axis of patients with 21-hydroxylase deficiency (21OH-D) can be only partially balanced after treatment. This could interfere with the ghrelin/GH/ IGF1 axis, contributing to the poor auxological outcome of these patients. We studied the possible short term effects of corticosteroids administration on the ghrelin/GH/IGF1 and the CRF/ACTH/adrenal axes in CAH patients, examining thirty-seven 21OH-D patients (17 M, 20 F; 13 SW, 11 SV, 13 NC forms). The patients avoided for one day the evening doses of glico- and mineralo-corticoids; the morning after, two blood samples were drawn (8:00 a. m. and 10:30-11:00 a.m.), the first immediately before and the second after an evening+morning dose of therapy. In both samples glycaemia, ghrelin, GH, IGF1, CRF, ACTH, cortisol, D4-androstenedione (D4-A), 17OH-progesterone (17OHP), insulin, plasma renin activity (PRA) were assayed. As expected, the pre/post treatment evaluation showed a statistically significant rise in cortisol and a fall in ACTH, 17OHP and D4-A levels; the same pattern of cortisol was shown by ghrelin, glycaemia and PRA, while IGF1 levels decreased; no significant differences were found for Insulin, CRF and GH levels. Analysis in a multiple regression model, showed that plasma ghrelin changes were mainly due to changes of D4-A (pre and post therapy; F=6.465, P=0.0136) and at a minor extent to changes of GH (only post therapy; F=4.447, P=0.044). Ghrelin showed to be influenced from acute corticosteroid therapy as were the other hormones involved in the hypothalamic-pituitary-adrenal and GH/IGF1 axes; interestingly, a similar ghrelin/D4-A negative correlation was found from Gambineri et al. in a group of obese women with polycystic ovary syndrome; a potential negative effect on ghrelin levels can be hypothesized for the CAH patients whose androgens could not be well controlled with treatment.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
