Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing's syndrome

J. Majnik, N. Szücs, A. Patócs, M. Tóth, K. Balogh, I. Varga, E. Gláz, K. Rácz

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and β-crosslaps (β -CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 1970 yr). Serum OC and β-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5±12 ng/ml, meant±SD) and between 08:00 and 09:00 h (17.7±9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5±7.0 and 28.3±2.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3±12.2 to 21.8±9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8±15.9 to 24.1±14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5±4.6 ng/ml) and in patients with adrenal incidentalomas (12.2±6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in β-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.

Original languageEnglish
Pages (from-to)747-753
Number of pages7
JournalJournal of Endocrinological Investigation
Volume27
Issue number8
Publication statusPublished - Sep 2004

Fingerprint

Cushing Syndrome
Osteocalcin
Dexamethasone
Healthy Volunteers
Biomarkers
Hormones
Bone and Bones
Metyrapone
Adrenocorticotropic Hormone
Serum
glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine
Pituitary ACTH Hypersecretion
Injections
Adrenal incidentaloma
Immunoassay
Adenoma
Glucocorticoids
Hydrocortisone
Pharmaceutical Preparations

Keywords

  • Adrenal incidentaloma
  • Cushing's syndrome
  • Glucocorticoids
  • Serum β-crosslaps
  • Serum osteocalcin

ASJC Scopus subject areas

  • Endocrinology

Cite this

@article{1da78896090b439fa2034de72f46c4fb,
title = "Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing's syndrome",
abstract = "The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and β-crosslaps (β -CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 1970 yr). Serum OC and β-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5±12 ng/ml, meant±SD) and between 08:00 and 09:00 h (17.7±9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5±7.0 and 28.3±2.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3±12.2 to 21.8±9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8±15.9 to 24.1±14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5±4.6 ng/ml) and in patients with adrenal incidentalomas (12.2±6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in β-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.",
keywords = "Adrenal incidentaloma, Cushing's syndrome, Glucocorticoids, Serum β-crosslaps, Serum osteocalcin",
author = "J. Majnik and N. Sz{\"u}cs and A. Pat{\'o}cs and M. T{\'o}th and K. Balogh and I. Varga and E. Gl{\'a}z and K. R{\'a}cz",
year = "2004",
month = "9",
language = "English",
volume = "27",
pages = "747--753",
journal = "Journal of Endocrinological Investigation",
issn = "0391-4097",
publisher = "Editrice Kurtis s.r.l.",
number = "8",

}

TY - JOUR

T1 - Effect of single doses of dexamethasone and adrenocorticotrop hormone on serum bone markers in healthy subjects and in patients with adrenal incidentalomas and Cushing's syndrome

AU - Majnik, J.

AU - Szücs, N.

AU - Patócs, A.

AU - Tóth, M.

AU - Balogh, K.

AU - Varga, I.

AU - Gláz, E.

AU - Rácz, K.

PY - 2004/9

Y1 - 2004/9

N2 - The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and β-crosslaps (β -CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 1970 yr). Serum OC and β-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5±12 ng/ml, meant±SD) and between 08:00 and 09:00 h (17.7±9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5±7.0 and 28.3±2.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3±12.2 to 21.8±9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8±15.9 to 24.1±14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5±4.6 ng/ml) and in patients with adrenal incidentalomas (12.2±6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in β-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.

AB - The aim of the present study was to explore whether short-term changes in glucocorticoid activity which occur during dynamic testing of the pituitary adrenal axis with dexamethasone, ACTH, or metyrapone could have an effect on serum osteocalcin (OC) and β-crosslaps (β -CTx) concentrations in healthy subjects, in patients with adrenal incidentalomas and in those with Cushing's syndrome. The study included 40 healthy subjects (35 women and 5 men, age range 18-69 yr), 49 patients with adrenal incidentalomas (34 women and 15 men, age range 19-77 yr) and 8 patients with Cushing's syndrome (5 cortisol-producing adenomas and 3 pituitary-dependent Cushing's syndrome, 3 women and 5 men, age range 1970 yr). Serum OC and β-CTx concentrations were determined with electrochemoluminescent immunoassays at midnight, after an overnight fast between 08:00 and 09:00 h, after an overnight dexamethasone test (1 mg, orally) and after a single dose of metyrapone (30 mg/kg, orally). In healthy subjects and in patients with adrenal incidentalomas, serum bone marker concentrations were also measured after a single dose of ACTH injection (Cortrosyn depot, 1 mg im). Patients with Cushing's syndrome, but not those with adrenal incidentalomas, showed significantly lower serum OC at midnight (18.5±12 ng/ml, meant±SD) and between 08:00 and 09:00 h (17.7±9.6 ng/ml) compared to corresponding values obtained in healthy subjects (24.5±7.0 and 28.3±2.2 ng/ml, respectively). Serum OC concentrations were significantly decreased after a single dose of 1-mg dexamethasone in healthy subjects (from 28.3±12.2 to 21.8±9.5 ng/ml) and in patients with adrenal incidentalomas (from 29.8±15.9 to 24.1±14.1 ng/ml), whereas serum OC concentrations remained unchanged in patients with Cushing's syndrome. In addition, serum OC concentrations were even more markedly decreased after a single dose of ACTH injection in both healthy subjects (12.5±4.6 ng/ml) and in patients with adrenal incidentalomas (12.2±6.5 ng/ml). By contrast, metyrapone administration failed to induce significant changes in OC levels. There were no significant differences in β-CTx concentrations between the three groups or after drug treatments. Thus, serum OC levels should be interpreted with caution when obtained during testing of the pituitary-adrenal axis with dexamethasone or ACTH.

KW - Adrenal incidentaloma

KW - Cushing's syndrome

KW - Glucocorticoids

KW - Serum β-crosslaps

KW - Serum osteocalcin

UR - http://www.scopus.com/inward/record.url?scp=10244240632&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=10244240632&partnerID=8YFLogxK

M3 - Article

VL - 27

SP - 747

EP - 753

JO - Journal of Endocrinological Investigation

JF - Journal of Endocrinological Investigation

SN - 0391-4097

IS - 8

ER -