Cortisol Metabolism and the Pituitary-Adrenal Axis in Adults with Protein-Calorie Malnutrition

Smith, Stephen R.; Bledsoe, Turner; Chhetri, M K

doi:10.1210/jcem-40-1-43

Cited by 142 publications

(32 citation statements)

References 2 publications

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“…Failure to sup press plasma cortisol levels with dexamethasone has also been demonstrated in patients with alcoholism [10], anorex ia nervosa [1], and protein-calorie malnutrition [12]. In ad dition, up to 50% of endogenously depressed individuals have been reported to have a disinhibited HPA system ma nifested by failure to suppress plasma cortisol or an early cortisol escape from dexamethasone suppression [2, I !…”

Section: Introductionmentioning

confidence: 99%

The Dexamethasone Suppression Test as a Measure of Hypothalamic-Pituitary Feedback Sensitivity and its Relationship to Behavioral Arousal

et al. 1981

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A nonhuman primate model was used to evaluate the value of the dexamethasone suppression test as an index of hypothalamic-pituitary-adrenal responsiveness to arousal. In 8 rhesus monkeys plasma cortisol was suppressed by dexamethasone in a dose-dependent fashion at doses between 0.75 and 33 μg/kg. A replication study was performed 5 months later using a single dexamethasone dose (17 μg/kg) known to produce maximal plasma cortisol suppression. This yielded highly correlated results (r = 0.91, p < 0.005) suggesting that dexamethasone suppressibility may be a stable characteristic of individual animals. In 9 other animals whose arousal responses to a stressful procedure (nasogastric tube insertion) had been rated daily over a previous 3-month period, baseline plasma cortisol levels and the percent suppression of plasma cortisol by dexamethasone were evaluated. Baseline plasma cortisol levels did not significantly correlate with the degree of dexamethasone-suppression and the mean arousal ratings within animals. However, the postdexamethasone percent of baseline cortisol did correlate significantly (r = 0.75, p < 0.025) with individual mean arousal ratings. These preliminary results suggest that assessment of the sensitivity of an individual’s hypothalamic-pituitary glucocorticoid feedback system may be a better predictor than its baseline cortisol concentrations of its degree of behavioral arousal to stress.

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Section: Introductionmentioning

confidence: 99%

The Dexamethasone Suppression Test as a Measure of Hypothalamic-Pituitary Feedback Sensitivity and its Relationship to Behavioral Arousal

et al. 1981

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“…Two recent investigations, utilizing newer methodologies, reveal that the hypothalamic-pituitary-adrenal axis is not only intact and responds appropriately to various types of stimulation, including stress, but also may be in a state of slight hyperfunction. The first study (47) was of 10 adults with chronic protein calorie malnutrition associated with edema and hypoalbuminemia. Both plasma total cortisol and plasma free cortisol.…”

mentioning

confidence: 99%

Endocrine Adaptation to Malnutrition

Brasel

1980

Pediatr Res

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“…Furthermore, elevated plasma cortisol concentrations have been observed in pro tein-calorie malnourished individuals [24], which suggests that glucocorticoids are in volved in protein mobilization from lean body stores. Therefore, it was surprising to us that glutamic acid and casein compared to the fasted control group did not significantly alter PCC.…”

Section: Resultsmentioning

confidence: 99%

Effect of Nutrients on Plasma Corticosteroid Concentration in Cold-Stressed Rats

et al. 1993

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Little is known about the mechanisms as to how nutrients affect plasma corticosteroids in cold-stressed and starved animals. Therefore, cold-stressed rats (maintained at 7 °C) were fasted (control) or fed a balanced diet (casein 20wt%, fat 5 wt%, starch 70 wt% and vitamin-mineral premix 5 wt%) or the following dietary nutrients for 72 h: casein, lard, starch, glycerol, stearic acid, leucine or glutamic acid. The animals were then killed and plasma corticosteroid concentrations (PCC) were determined. PCC were significantly reduced (p < 0.05) in cold-stressed animals fed a balanced diet (16.95 µg/100 ml plasma) compared to the fasted cold-stressed controls (FCSC) (24.16µg/100ml plasma). Additionally, corticosteroid concentrations (µg/100 ml plasma) of animals fed the following specific nutrients were also significantly lower than the FCSC values: starch (15.53), lard (12.01), stearic acid (12.74), glycerol (13.32) and leucine (16.03). Casein and glutamic acid did not significantly alter plasma corticosteroid levels relative to the FCSC concentration. It is concluded that certain specific building blocks of nutrient classes, i.e. stearic acid or glycerol, can alter PCC to the same extent as the parent compound (lard), however the individual components of casein, a complex nutrient, i.e. leucine, a ketogenic amino acid, versus glutamic acid, a glycogenic amino acid, may elicit a different PCC effect.

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Cortisol Metabolism and the Pituitary-Adrenal Axis in Adults with Protein-Calorie Malnutrition

Cited by 142 publications

References 2 publications

The Dexamethasone Suppression Test as a Measure of Hypothalamic-Pituitary Feedback Sensitivity and its Relationship to Behavioral Arousal

The Dexamethasone Suppression Test as a Measure of Hypothalamic-Pituitary Feedback Sensitivity and its Relationship to Behavioral Arousal

Endocrine Adaptation to Malnutrition

Effect of Nutrients on Plasma Corticosteroid Concentration in Cold-Stressed Rats

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