Subnormal Plasma Dehydroisoandrosterone to Cortisol Ratio in Anorexia Nervosa: A Second Hormonal Parameter of Ontogenic Regression*

Affectionate Communication Received from Spouses Predicts Stress Hormone Levels in Healthy Adults

“…When mathematically expressed as cortisol divided by DHEA-S (rather than the obverse), CDR should show direct associations with stress, since stress increases levels of the numerator (cortisol) and decreases levels of the denominator (DHEA-S) (see Parker, Levin, & Lifrak, 1985). Previous investigations have demonstrated that CDR is directly associated with multiple diverse forms of stress, including surgical stress (Ozasa, Kita, Inoue, & Mori, 1990), bodily stress due to anorexia nervosa (Zumoff et al, 1983) or injury (Butcher, Killampalli, Lascelles, Wang, Alpar, & Lord, 2005), laboratory induced stress (Whetzel et al, 2006) or fear (Grillon, Pine, Baas, Lawley, Ellis, & Charney, 2005), and the stress of military school (Morgan et al, 2004), and can be significantly decreased by a cognitivebehavioral stress management intervention (Cruess et al, 1999).…”

Changes in Bone Turnover Markers and Menstrual Function After Short-term Oral DHEA in Young Women with Anorexia Nervosa

“…(2) While physical activity is important for maintaining bone mass, patients with AN often exercise excessively, leading to weight loss with subsequent hormonal alterations that predispose these patients to skeletal losses. (3)(4)(5)(6)(7)(8) Because adolescence is a critical period for the acquisition of bone mineral, (9,10) the identification of safe and effective strategies to preserve bone density in these young women is an important public health issue.…”

“…Adrenocorticotropic hormone stimulation tests have suggested decreased adrenal 17-20 lyase activity in AN, with a predominance of glucocorticoid over androgenic pathways. (6,7) This enzymatic block results in increased cortisol and decreased DHEA production. (6,7) In adolescents with AN, DHEA and gonadal steroid levels revert back to the range of a prepubertal child.…”

Dysfunction of the Hypothalamic-Pituitary-Adrenal axis in HIV infection and disease

“…In contrast, the same study demonstrated an intact ovarian androgen responsiveness to hCG stimulation. 37,38 Influence of altered steroid production on immune status in AIDS Plasma DHEA concentrations correlate positively with the CD4 cell count. 39 Also, certain studies demonstrate a negative linear correlation between CD4 count and cortisol levels, 40 while others do not.…”

“…35 Such a pattern of high cortisol and reduced DHEA may be due to a decreased adrenal 17,20-lyase activity. 36 In a study investigating ovarian and adrenal function in HIV-infected women with AIDS, significantly reduced DHEA and increased cortisol responses to ACTH were demonstrated. The ratio of the DHEA to cortisol response (an index of shunting away from adrenal androgen secretion and towards increased cortisol production) was significantly decreased in women with AIDS-related wasting syndrome compared to estrol acetate exhibits intrinsic glucocorticoid activity and prolonged administration can induce secondary adrenal insufficiency.…”