The Cortisol Response to Normal and Nocturnal Awakening

2000 ◽  
Vol 14 (1) ◽  
pp. 24-28 ◽  
Author(s):  
F. Hucklebridge ◽  
A. Clow ◽  
H. Rahman ◽  
P. Evans
Keyword(s):  
Area Under The Curve ◽  
Secretory Activity ◽  
Linear Increase ◽  
Cortisol Response ◽  
The Awakening ◽  
Basal Cortisol ◽  
Free Cortisol ◽  
Main Effect ◽  
Nocturnal Awakening ◽  
Night Awakening

Abstract Free cortisol as measured in saliva increases markedly following awakening. It is not clear, however, whether this is truly a stress-neuroendocrine response to awakening or a manifestation of the hypothalamic-pituitary-adrenal (HPA) circadian cycle. We investigated whether the awakening cortisol response can be generated in the middle of nocturnal sleep, when secretory activity in the HPA axis is low. In a within subject design, salivary cortisol response was measured under three different awakening conditions: (1) awakening at the normal morning awakening time; (2) awakening four hours prior to normal awakening time, and (3) awakening the following morning after interrupted sleep. The overall main effect was a linear increase in free cortisol following awakening with no significant interaction with awakening condition. Cortisol levels, as determined by area under the cortisol curve calculated with reference to zero, did differ by awakening condition. The two morning awakening conditions were comparable but values were lower for night awakening. Area under the curve change (calculated with reference to the first awakening cortisol base value), however, did not distinguish the three awakening conditions. We conclude from these data that there is a clear free cortisol response to awakening for both nocturnal and morning awakening although the absolute levels produced are lower for nocturnal awakening when basal cortisol is low. Nocturnal interruption of sleep did not affect the subsequent morning response.

Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity

Life Sciences ◽  
2001 ◽  
Vol 68 (18) ◽  
pp. 2093-2103 ◽  
Author(s):  
S. Edwards ◽  
A. Clow ◽  
P. Evans ◽  
F. Hucklebridge
Keyword(s):  
Secretory Activity ◽  
Cortisol Response ◽  
Diurnal Cortisol ◽  
The Awakening

Ultrasound Measures of Bone and the Diurnal Free Cortisol Cycle: A Positive Association with the Awakening Cortisol Response in Healthy Premenopausal Women

2002 ◽  
Vol 70 (6) ◽  
pp. 463-468 ◽  
Author(s):  
K. Brooke-Wavell ◽  
A. Clow ◽  
S. Ghazi-Noori ◽  
P. Evans ◽  
F. Hucklebridge
Keyword(s):  
Premenopausal Women ◽  
Positive Association ◽  
Cortisol Response ◽  
The Awakening ◽  
Free Cortisol

EVALUATION OF PITUITARY-ADRENAL FUNCTION IN CHILDREN

1965 ◽  
Vol 48 (1) ◽  
pp. 81-90 ◽  
Author(s):  
B. van der Wal ◽  
T. Wiegman ◽  
J. F. Janssen ◽  
A. Delver ◽  
D. de Wied
Keyword(s):  
Blood Pressure ◽  
Body Temperature ◽  
Diastolic Blood Pressure ◽  
Linear Increase ◽  
Significant Rise ◽  
Moderate Increase ◽  
Specific Stimulus ◽  
Lysine Vasopressin ◽  
Free Cortisol ◽  
Pituitary Adrenal Axis

ABSTRACT The reactivity of the hypothalamico-pituitary-adrenal axis was determined in 48 children, not suffering from any endocrine disorder. The free cortisol (F)- and corticosterone (B) content of plasma was determined in response to ACTH (clinical corticotrophin; A1 peptide), a corticotrophin releaser (lysine vasopressin) and a non specific stimulus (bacterial polysaccharide) as compared to saline. The two ACTH-preparations infused over one hour in a dose of 5 IU per child elicited a marked increase in both F and B. Lysine vasopressin in a dose of 0.5 IU per year of age similarly infused, exhibited a distinct linear increase in the two circulating cortical steroids, although the effect of this octapeptide was smaller than that of the two ACTH-preparations. Blood pressure was also measured during the infusion with vasopressin or saline. The systolic blood pressure was not significantly affected by vasopressin, but a significant rise in diastolic blood pressure was found. No correlation between the increase in diastolic blood pressure and in blood corticoids in response to vasopressin, was found. The intravenous administration of a relatively small amount of pyrifer caused a moderate increase in circulating F which was significant only at 4 and 6 hours after the injection of the pyrogen. The B content did not increase significantly above that of saline treated control children, presumably because of the relatively weak corticotrophic activity of the pyrogen under these conditions. A positive linear relation between body temperature and time was found. No correlation between increase in body temperature and increase in circulating F could be demonstrated.

THE EFFECTS OF DEXAMETHASONE AND ANDROGENS ON SEXUAL RECEPTIVITY OF FEMALE RHESUS MONKEYS

1971 ◽  
Vol 51 (3) ◽  
pp. 575-588 ◽  
Author(s):  
B. J. EVERITT ◽  
J. HERBERT
Keyword(s):  
Rhesus Monkeys ◽  
Testosterone Propionate ◽  
Secretory Activity ◽  
Urinary Free Cortisol ◽  
Sexual Receptivity ◽  
Adrenal Androgens ◽  
Electrolyte Metabolism ◽  
Free Cortisol ◽  
Female Rhesus ◽  
The Central Nervous System

SUMMARY The effect of dexamethasone, given either alone or together with testosterone propionate or androstenedione, was studied in nine female rhesus monkeys (paired with three males) by making quantitative observations on behaviour in the laboratory. Dexamethasone (0·5 mg/kg/day) given to oestrogen-treated ovariectomized female monkeys made them sexually unreceptive, and there was an associated decline in the level of the male's mounting activity. Testosterone propionate (100 or 200 μg/day) reversed completely the effects of dexamethasone on sexual behaviour. Androstenedione (100, 200 or 400 μg/day) had similar, but less marked, effects whereas cortisol (10 mg/day) or progesterone (100, 200 or 500 μg/day) were ineffective. Treating a female with testosterone prevented dexamethasone from reducing sexual receptivity. Parallel determinations of urinary free cortisol showed that the dexamethasone had suppressed the secretory activity of the adrenal cortex. There were no consistent changes, under any treatment, in the females' vaginal epithelia, sexual skins or clitorides, or in their water or electrolyte metabolism. These findings indicate that adrenal androgens regulate sexual receptivity in these female primates, probably by an action on the central nervous system.

One microgram is the lowest ACTH dose to cause a maximal cortisol response. There is no diurnal variation of cortisol response to submaximal ACTH stimulation

1997 ◽  
pp. 172-175 ◽  
Author(s):  
G Dickstein ◽  
D Spigel ◽  
E Arad ◽  
C Shechner
Keyword(s):  
Diurnal Variation ◽  
Cortisol Level ◽  
Low Dose ◽  
Cortisol Response ◽  
Acth Stimulation ◽  
Baseline Cortisol ◽  
Maximal Stimulation ◽  
Basal Cortisol ◽  
Basal Cortisol Level ◽  
Cortisol Responses

There are many suggestions in the literature that the adrenal gland is more sensitive to ACTH in the evening than in the morning. However, all these studies in humans were conducted when the basal cortisol level was not suppressed, and were based on the observation that, after stimulation, the increases in cortisol differed, though the peak values were the same. To examine this, we established the lowest ACTH dose that caused a maximal cortisol stimulation even when the basal cortisol was suppressed, and used a smaller dose of ACTH for morning and evening stimulation. The lowest ACTH dose to achieve maximal stimulation was found to be 1.0 microgram, with which dose cortisol concentration increased to 607.2 +/- 182 nmol/l, compared with 612.7 +/- 140.8 nmol/l with the 250 micrograms test (P > 0.3). The use of smaller doses of ACTH (0.8 and 0.6 microgram) achieved significantly lower cortisol responses (312 +/- 179.4 and 323 +/- 157.3 nmol/l respectively; both P < 0.01 compared with the 1 microgram test). When a submaximal ACTH dose (0.6 microgram) was used to stimulate the adrenal at 0800 and 1600 h, after pretreatment with dexamethasone, no difference in response was noted at either 15 min (372.6 +/- 116 compared with 394.7 +/- 129.7 nmol/l) or 30 min (397.4 +/- 176.6 compared with 403 +/- 226.3 nmol/l; P > 0.3 for both times). These results show that 1.0 microgram ACTH, used latterly as a low-dose test, is very potent in stimulating the adrenal, even when baseline cortisol is suppressed; smaller doses cause reduction of this potency. Our data show that there is probably no diurnal variation in the response of the adrenal to ACTH, if one eliminates the influence of the basal cortisol level and uses physiologic rather than superphysiologic stimuli.

scholarly journals Patients With Apparently Nonfunctioning Adrenal Incidentalomas May Be at Increased Cardiovascular Risk Due to Excessive Cortisol Secretion

2014 ◽  
Vol 99 (8) ◽  
pp. 2754-2762 ◽  
Author(s):  
Ioannis I. Androulakis ◽  
Gregory A. Kaltsas ◽  
Georgios E. Kollias ◽  
Athina C. Markou ◽  
Aggeliki K. Gouli ◽  
...  
Keyword(s):  
Low Dose ◽  
Area Under The Curve ◽  
Urinary Free Cortisol ◽  
Model Assessment ◽  
Homeostasis Model Assessment ◽  
Acth Stimulation ◽  
Adrenal Imaging ◽  
Free Cortisol ◽  
Suppression Test ◽  
Dexamethasone Suppression

Context: Although adrenal incidentalomas (AIs) are associated with a high prevalence of cardiovascular risk (CVR) factors, it is not clear whether patients with nonfunctioning AI (NFAI) have increased CVR. Objective: Our objective was to investigate CVR in patients with NFAI. Design and Setting: This case-control study was performed in a tertiary general hospital. Subjects: Subjects included 60 normotensive euglycemic patients with AI and 32 healthy controls (C) with normal adrenal imaging. Main Outcome Measures: All participants underwent adrenal imaging, biochemical and hormonal evaluation, and the following investigations: 1) measurement of carotid intima-media thickness (IMT) and flow-mediated dilatation, 2) 2-hour 75-gram oral glucose tolerance test and calculation of insulin resistance indices (homeostasis model assessment, quantitative insulin sensitivity check, and Matsuda indices), 3) iv ACTH stimulation test, 4) low-dose dexamethasone suppression test, and 5) NaCl (0.9%) post-dexamethasone saline infusion test. Results: Based on cutoffs obtained from controls, autonomous cortisol secretion was documented in 26 patients (cortisol-secreting AI [CSAI] group), whereas 34 exhibited adequate cortisol and aldosterone suppression (NFAI group). IMT measurements were higher and flow-mediated vasodilatation was lower in the CSAI group compared with both NFAI and C and in the NFAI group compared with C. The homeostasis model assessment index was higher and quantitative insulin sensitivity check index and Matsuda indices were lower in the CSAI and NFAI groups compared with C as well as in CSAI compared with the NFAI group. The area under the curve for cortisol after ACTH stimulation was higher in the CSAI group compared with the NFAI group and C and in the NFAI group compared with C. In the CSAI group, IMT correlated with cortisol, urinary free cortisol, and cortisol after a low-dose dexamethasone suppression test, whereas in the NFAI group, IMT correlated with area under the curve for cortisol after ACTH stimulation and urinary free cortisol. Conclusions: Patients with CSAI without hypertension, diabetes, and/or dyslipidemia exhibit adverse metabolic and CVR factors. In addition, NFAIs are apparently associated with increased insulin resistance and endothelial dysfunction that correlate with subtle but not autonomous cortisol excess.

scholarly journals Hypothalamic-pituitary-adrenal axis function in patients with bipolar disorder

2004 ◽  
Vol 184 (6) ◽  
pp. 496-502 ◽  
Author(s):  
Stuart Watson ◽  
Peter Gallagher ◽  
James C. Ritchie ◽  
I. Nicol Ferrier ◽  
Allan H. Young
Keyword(s):  
Bipolar Disorder ◽  
Hpa Axis ◽  
Cortisol Response ◽  
Hypothalamic Pituitary Adrenal ◽  
The Core ◽  
Basal Cortisol ◽  
Suppression Test ◽  
Cortisol Levels ◽  
Dexamethasone Suppression ◽  
Pituitary Adrenal Axis

BackgroundHypothalamic-pituitary-adrenal (HPA) axis function, as variously measured by the responses to the combined dexamethasone/ corticotrophin-releasing hormone (dex/ CRH) test, the dexamethasone suppression test (DST) and basal cortisol levels, has been reported to be abnormal in bipolar disorder.AimsTo test the hypothesis that HPA axis dysfunction persists in patients in remission from bipolar disorder.MethodSalivary cortisol levels and the plasma cortisol response to the DST and dex/CRH test were examined in 53 patients with bipolar disorder, 27 of whom fulfilled stringent criteria for remission, and in 28 healthy controls. Serum dexamethasone levels were measured.ResultsPatients with bipolar disorder demonstrated an enhanced cortisol response to the dex/CRH test compared with controls (P=0.001). This response did not differ significantly between remitted and non-remitted patients. These findings were present after the potentially confounding effects of dexamethasone levels were accounted for.ConclusionsThe dex/CRH test is abnormal in both remitted and non-remitted patients with bipolar disorder. Thismeasure of HP Aaxis dysfunction is a potential trait marker in bipolar disorder and thus possibly indicative of the core pathophysiological process in this illness.

scholarly journals Desmopressin Test in Silent Corticothoph Pituitary Adenomas, a Preliminary Study - a Comparison With Cushing Disease

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A642-A642
Author(s):  
Martha Katherine Huayllas ◽  
Marilena Nakaguma ◽  
Mirela Costa de Miranda ◽  
Priscila Rosada Montebello Mitsuyama Cardoso
Keyword(s):  
Pituitary Adenomas ◽  
Preoperative Evaluation ◽  
Pituitary Tumors ◽  
Immunohistochemical Analysis ◽  
Pituitary Surgery ◽  
High Recurrence Rate ◽  
Cushing Disease ◽  
Basal Cortisol ◽  
Free Cortisol ◽  
Cortisol Increase

Abstract Introduction: Silent corticothop adenomas (SCAs) account for 9 to 19% of nonfunctioning pituitary adenomas and behave as the most agressive pituitary tumors with more invasiveness and high recurrence rate. The identification of these patients during the preoperative stage could predict better surgery results. Some authors refer to high basal ACTH level in the preoperative evaluation as the only marker but until this date, there are no clinical and hormonal markers that could predict its occurrence. The aim of this study is to evaluate the response to desmopressin test and the presence of silent corticothoph tumors. Patients and Methods: Among 496 patients underwent pituitary surgery, 425 were pituitary adenomas, (106 were acromegaly, 46 Cushing disease, 10 prolactinomas, 263 nonfunctioning adenomas). Twenty-three patients, 17 with Cushing disease, (CD), mean age: 31 y, 13 female and 4 male) and 6 patients with SCA (mean age: 47 y, 5 female and 1 male) had positive ACTH confirmed by immunohistochemical analysis. Clinical characteristics: in the CD group, 53% had hypertension (9/17), 42% diabetes (7/17), 100% dyslipidemia, BMI was 30.7 kg/m2. Among SCA group, 67% hypertension, 50% diabetes, 50% dyslipidemia, BMI was 28 kg/m2. All patients were evaluated with basal ACTH and DHEAS before surgery. Patients with SCA underwent desmopressin test and were compared to CD. Dexamethasone suppression test (DST 1 mg) and 24-hour free urinary test was performed in patients with CD and in two patients with SCA. Response to desmopressin test was considered positive when increase in cortisol was above 20% and in ACTH of 35% using chemiluminescence assay (Immulite 2000). Results: Among CD group, the median (med) basal ACTH was 75.9 pg/mL (30.9 to 211), the med basal cortisol was 22.5 µg/dL (14.5 to 43.5), the med DHEAS was 170 µg/dL (33 to 465), the med 24h urinary free cortisol of 454.5 µg/24 h (149 to 1673) and med basal cortisol after DST 1mg of 15.4 µg/dL (4.7 to 31.5). Among SCA, med basal ACTH was 19.4 pg/mL (9.5 to 65.5), the med basal cortisol was 9.5 µg/dL (7.8 to 16.4) and the med DHEAS was 104.5 µg/dL (82 to 127). Only 4 patients with CD had macroadenomas. All of them responded with ACTH increase (med increase of 98%, 31.6 to 377%), and only 4 did not respond to cortisol increase (med increase of 54.4%, 0 to 167%). All patients with SCA had macroadenomas. Only one patient did not respond to ACTH increase (med increase of 123.5%, 9.5 to 1522%, 9.5 to 1522%), and 3 patients did not respond to cortisol increase (med increase of 17.9%, 0 to 234%). Discussion: SCA are invasive tumors, with high recurrence and tests predicting their occurrence are missing. We hypothesized that as ACTH is present in the adenoma a response to desmopressin test could exist (like CRH). Conclusion:The desmopressin test can be a useful tool in the evaluation of SCA and can predict pathological phenotype in preoperative tumors.

Postprandial hormone response after endurance or resistance exercise in obese women

2017 ◽  
Vol 13 (4) ◽  
pp. 227-235
Author(s):  
P.M. Davitt ◽  
G.C. Henderson ◽  
A.J. Walker ◽  
S.M. Arent
Keyword(s):  
Area Under The Curve ◽  
Exercise Bout ◽  
Fat Free Mass ◽  
Hormonal Changes ◽  
Obese Women ◽  
Post Exercise ◽  
Postprandial Period ◽  
Single Bout ◽  
Main Effect ◽  
Total Body

Physiological changes with endurance exercise (EE) and resistance training (RT) are likely influenced by the metabolic and hormonal response to each exercise bout, but may be blunted in obese individuals. To compare acute effects of EE, RT, and a control upon hormonal changes in obese women, sedentary, obese women (n=12) participated in a randomised crossover-design study on 3 occasions. EE consisted of treadmill walking (65% VO2max for 1 h). A total-body RT workout consisted of 3 sets of 10 repetitions, 90 s rest for 8 exercises at 90-100% of 10RM. Blood samples were taken 30 min before exercise (0 min), 30 min post-exercise (120 min), and again at 200, 280, and 520 min to assess changes in growth hormone (GH), cortisol, and insulin throughout the postprandial period. A 20 kcal/kg fat-free mass (FFM) meal was given after post-exercise blood sample. There was a main effect of condition for GH ΔAUC (change in area under the curve), with both RT and EE significantly different from the control (RT = 463.0±138.2; EE = 243.2±131.6; Control = -90.4±157.6 ng/ml * 400 min, P<0.02, Control vs EE, effect size (ES) = 2.3; Control vs RT, ES=3.7; EE vs RT, ES=1.6). There were no condition effects for cortisol or insulin ΔAUC. There were no significant time-by-condition interactions for any variables. In obese women, circulating GH concentration is enhanced in the postprandial state following a single bout of either EE or RT, with the GH response being more robust than cortisol or insulin. As circulating GH has shown to be reduced in obesity, the present observations could be considered beneficial, particularly alongside the absence of enhanced cortisol level after exercise.

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