Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T13:55:57.169Z Has data issue: false hasContentIssue false
  • English
  • Français

Baseline ACTH values and its relation to pre- and post- dexamethasone cortisol levels in depressed patients

Published online by Cambridge University Press:  28 April 2020

J.A. Cabranes ,
I. Almoguera ,
J.L. Ayuso ,
E. Garcia-Camba  and
J. del Olmo
J.A. Cabranes*
Affiliation:
Nuclear Medicine Service
I. Almoguera
Affiliation:
Nuclear Medicine Service
J.L. Ayuso
Affiliation:
Department of Medical Psychiatry and Psychology, Hospital Universitario San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain
E. Garcia-Camba
Affiliation:
Department of Medical Psychiatry and Psychology, Hospital Universitario San Carlos, Facultad de Medicina, Universidad Complutense, Madrid, Spain
J. del Olmo
Affiliation:
Nuclear Medicine Service
*
Corresponding author: Correspondance à adresser au : Dr. J. A. Cabranes Diaz, Servicio de Medicina Nuclear Hospital Universitario San Carlos, c/ Isaac Peral s/n 28040 Madrid, (Spain)
Get access

Summary

Baseline ACTH values were assessed in a large sample of depressed patients to establish correlations with baseline and post-dexamethasone cortisol levels. No statistically significant differences were found, indicating that excessive ACTH release mighl not be responsible for the elevated cortisol levels and nonsuppression by dexamethasone frequently observed in these patients. Other extrahypophyseal factors may mediate these responses.

Résumé

Résumé

Les valeurs de la sécrétion basale d'ACTH ont été mesurées dans une population de 117 déprimés (R.D.C. : épisode dépressif majeur). Ceux-ci présentaient un poids proche de la normale, n’étaient traités par aucun médicament interférant avec les résultats du DST. Les témoins étaient 30 schizophrènes d'une part, et 25 dépressions secondaires (obsessions, phobies, alcoolisme) ainsi que 95 sujets normaux.

Afin d’éviter un stress, les prélèvements étaient réalisés grâce à un cathéter à 8 h, 8 h 30 et 9 h le premier jour, puis après administration de dexaméthasone à : 8 h - 8 h 30 - 9 h, 16 h - 16 h 30 - 17 h, 23 h - 23 h 30 - 24 h le lendemain.

Ces résultats ont été comparés aux valeurs de la sécrétion basale du cortisol et aux résultats d'un test de freinage par la dexaméthasone (DST). Les valeurs de la sécrétion d’ACTH dans les différentes populations malades sont présentées tableau 1 ; il n’existe pas de différence significative entre elles. Le groupe des 117 déprimés présente cependant des valeurs plus élevées que les témoins (figure 1). Nous n'avons pas trouvé de corrélation entre les valeurs de la sécrétion basale d’ACTH et celles du cortisol (sécrétion basale ou valeurs post DST) (tableau 2). L’influence de la distinction entre malades bipolaires et unipolaires sur les résultats est présentée tableau 3. L’absence de corrélation entre valeurs de la sécrétion d'ACTH et de cortisol suggère qu'une augmentation de la sécrétion d’ACTH n’explique pas les taux élevés de cortisol fréquemment retrouvés chez les patients déprimés ou l’absence de freinage par la dexaméthasone lors du DST. D’autres facteurs extrahypophysaires pourraient expliquer ces anomalies. Cependant, nos résultats pourraient être expliqués par des biais méthodologiques : valeur basale unique, écarts-types élevés etc…

Keywords

DepressionACTHCortisolD.S.T.DépressionACTHCortisolD.S.T.
Type
Research Article
Information
Psychiatry and Psychobiology , Volume 2 , Issue 1 , 1987 , pp. 28 - 33
Copyright
Copyright © European Psychiatric Association 1987

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References/Bibliographie

Beck-Friis, J., Ljunggren, G., Thoren, M., Von Rosen, D., Kjellman, B.F., Wettferberg, L. - Melatonin, cortisol and ACTH in patients with major depressive disorder and healthy humans with special reference to the outcome of the dexamethasone suppression test. Psychoneuroendocrinology 1985; 10:173–186.CrossRefGoogle ScholarPubMed
Cabranes, J.A., Almoguera, F, Del Olmo, J., Ayuso-Gutierrez, J.F., Garcia-Camba, J.E., Barrio, O. - Methodological criteria in the- evaluation of the hypothalamic-pituitary-adrenal axis: is stress relevant? 14 th C.I.N.P. Congress (Abstract, p-670), Florence, 1984.Google Scholar
Carnfy, M.W.P., Roth, M., Garsidf, R.F., - The diagnosis of depressive- syndromes and the prediction of ECT response. Br J Psychiatry 1985; III: 659–684.Google Scholar
Carr, D.B., Wool, C., Lydiard, R.B., Fishfr, J., Gelenberg, A., Klerman, G. - Rate sensitive inhibition of ACTH release in depression. Am J Psychiatry 1984; 141:590–592.Google ScholarPubMed
Carroll, B.J. - Plasma cortisol levels in depression, In: Davies, B., Carroll, B.J., Mowbray, R M. eds.: Depressive illness. Some research studies, 69–86, Charles C. Thomas, Springfield, 1972.Google Scholar
Carroll, B. F, Feinberg, M., Gredfn, J.F., Tarike, F, Albala, A., Haskett, R.F., James, N., Kronfold, Z., Lohr, N., de Vignf, J.P., Young, F. - A specific laboratory test for the diagnosis of melancholia. Standardization, validation and clinical utility. Arch Gen Psychiatry 1981; 38:15–22.CrossRefGoogle Scholar
Demisch, K., Dfmisch, F., Bochnik, H.J., Schulz, F. - Comparison of the ACTH suppression test and dexamethasone suppression test in depressed patients. Am J Psychiatry 1983; 140:1511–1512.Google ScholarPubMed
Engeland, W.C., Dallman, M. F. - Neural mediation of compensatory adrenal growth. Endocrinology 1976; 99:1659–1662.CrossRefGoogle ScholarPubMed
Evans, C.J., Erdely, E., Weber, E., Barchas, J.D. - Identification of proopiomelancortin related peptides in human adrenal medulla. International Narcotics Research Conference, (Abstract. p-184), 1983.Google Scholar
Fang, V.S., Tricon, B.J., Robertson, A., Meltzer, H. Y. - Plasma ACTH and cortisol levels in depressed patients: relation to dexamethasone suppression Test. Life Sci 1981; 29:931–938.CrossRefGoogle ScholarPubMed
Fehm, H.L., Klein, E., Holl, R., Voigt, K.H. - Evidence for extrapituitary mechanism mediating the morning peak of plasma cortisol in man. J Clin Endocrinol Metab 1984; 58:410–414.CrossRefGoogle Scholar
Gold, P.W., Chrousos, G., Kellner, C., Post, R., Roy, A., Augerinos, P., Schulte, H, Oldfield, E., Loriaux, L. - Psychiatric implications of basic and clinical studies with corticotropinreleasing factor. Am J Psychiatry 1984; 141:619–627.Google Scholar
Gullner, H.G., Nicholson, W.E., Wilson, M.G., Bartter, F.C., Orth, D.N. - The response of plasma immunoreactive adrenorcorticotropin, β endorphin β lipotropin, lipotropin and cortisol to experimentally induced pain in normal subjects. Clin Sci 1982; 63:397–400.CrossRefGoogle ScholarPubMed
Holsboer, F., Doerr, H.G., Gerken, A., Muller, O.A., Sippell, W.G. - Cortisol II-deoxycortisol and ACTH concentrations after dexamethasone in depressed patients and healthy volunteers. Psychiatry Res 1984; 11:15–23.CrossRefGoogle Scholar
Kalin, N.H, Risch, S.C., Cohen, R M., Insel, T., Murphy, D.L. - Dexamethasone fails to suppress β endorphin plasma concentrations in humans and Rhesus monkeys. Science 1980; 209:827–829.CrossRefGoogle ScholarPubMed
Kalin, N.H, Weilwe, S.J., Shelton, S.E. - Plasma ACTH and cortisol concentrations before and after dexamethasone. Psychiatry Res 1982; 7:87–92.CrossRefGoogle ScholarPubMed
Lypka, A., Lazowski, I, Szczudlik, A., Wasek, K. - The depot form of glucocorticoid decreases cortisol but not ACTH and β endorphin levels in human plasma. Horm Metab Res 1983; 15:104–108.CrossRefGoogle Scholar
Lowy, M.T., Reder, A.T., Antel, J.P., Meltser, H.Y. - Glucocorticoid resistance in depression: the dexamethasone suppression test and lymphocyte sensitivity to dexamethasone. Am J Psychiatry 1984; 141:1365–1370.Google ScholarPubMed
Meier, A.H. - Daily variation in concentration of plasma corticosteroid in hypophysectomized rats. Endocrinology 1976; 98:1475–1479.CrossRefGoogle ScholarPubMed
Nasr, S, Pandey, G., Davis, J. - Effects of dexamethasone on cortisol and ACTH in depressed outpatients and Controls. VIIth World Congress of Psychiatry, Abstract, p-214, Vienna, 1983.Google Scholar
Ottenweller, I.E., Meier, A.H. - Adrenal innervation may be an extrapituitary mechanism able to regulate adrenocortical rhythmicity in rats. Endocrinology 1982; 111:1334–1338CrossRefGoogle ScholarPubMed
Pedersen, R.C., Brownie, A.C. - Adrenocortical response to corticotropin is potentiated by part of the amino-terminal region of pro-corticotropin/endorphin. Proc Natl Acad Sci USA 1980; 77:2239–2241.CrossRefGoogle ScholarPubMed
Reus, V.I., Joseph, M.S., Dallman, M.F. - ACTH levels after the dexamethasone suppression test in depression. N Engl J Med 1982; 300:238–239.Google Scholar
Schlechte, J.A., Sherman, B. - Lymphocyte glucocorticoid receptor biding in depressed patients with hypercortisolemia. Psychoneuroendocrinology 1985; 10:464–474.CrossRefGoogle Scholar
Sherman, B., Pfohl, B., Winokur, G. - Dissociation of plasma cortisol and ACTH responses to dexamethasone in healthy subjects and depressed patients. Clin Res 1982; 30:722–729.Google Scholar
Yerevanian, B.I., Woolf, P.D. - Plasma ACTH levels in primary depression: relationship to the 24-hour dexamethasone suppression test. Psychiatry Res 1983; 9:45–51.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.