Gender‐specific co‐activation of arginine vasopressin and the hypothalamic–pituitary–adrenal axis during stress. (20th October 2014)

• Record Type: Journal Article
• Authors: Kacheva, S.; Kolk, K.; Morgenthaler, N.G.; Brabant, G.; Karges, W.
• Is Part Of: Clinical endocrinology. Volume 82:Number 4(2015:Apr.)
• Page Start: 570
• Page End: 576
• Publication Date: 2014-10-20
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.12608
• Languages: English
• ISSNs: 0300-0664

Abstract

<abstract abstract-type="main" id="cen12608-abs-0001"> <title>Summary</title> <sec id="cen12608-sec-0001" sec-type="section"> <title>Objective</title> <p>To study the interaction between copeptin and hypothalamic–pituitary–adrenal (HPA) activation in men and women during hypoglycaemic stress.</p> </sec> <sec id="cen12608-sec-0002" sec-type="section"> <title>Design and patients</title> <p>A prospective study in 118 patients (mean age 47·7 ± 13·6 years, <italic>n</italic> = 52 women) undergoing insulin tolerance testing for suspected pituitary dysfunction.</p> </sec> <sec id="cen12608-sec-0003" sec-type="section"> <title>Measurements</title> <p>Serum copeptin was measured in serially collected blood samples and assessed in relation to ACTH, cortisol and other endocrine parameters.</p> </sec> <sec id="cen12608-sec-0004" sec-type="section"> <title>Results</title> <p>Symptomatic hypoglycaemia (mean glucose nadir, 1·6 ± 0·5 mmol/l) resulted in a rapid significant increase of serum copeptin. Individuals with impaired pituitary function had lower stress‐induced copeptin levels (median, 6·26 pmol/l) than patients with intact pituitary (8·46 pmol/l, <italic>P</italic> < 0·001). A weak overall correlation between stress‐induced copeptin and cortisol levels was observed (<italic>r</italic><sub>s</sub> = 0·31, <italic>P</italic> < 0·001). In female individuals, there was a positive correlation between stress‐induced copeptin and ACTH (<italic>r</italic><sub>s</sub> = 0·47, <italic>P</italic> < 0·001) or cortisol levels (<italic>r</italic><sub>s</sub> = 0·42, <italic>P</italic> = 0·002), while in males, no correlation with ACTH levels (<italic>r</italic><sub>s</sub> = 0·03, <italic>P</italic> = 0·75) and poor correlation with cortisol levels (<italic>r</italic><sub>s</sub> = 0·24, <italic>P</italic> = 0·045) was observed. Patients with central diabetes insipidus showed lowest baseline (2·20 pmol/l) and stimulated copeptin levels (3·68 pmol/l).</p> </sec> <sec id="cen12608-sec-0005" sec-type="section"> <title>Conclusions</title> <p>The data from this study indicate that stress‐induced release of AVP in women, but not in men, is linked to the co‐activation of the hypothalamic–pituitary–adrenal system.</p> </sec> </abstract>