ORIGINAL ARTICLE
Adrenocorticotropic hormone and dehydroepiandrosterone sulfate levels of rheumatoid arthritis patients treated with glucocorticoids
Authors
Masao Yukioka1 , Yoshio Komatsubara1, Kazuhiko Yukioka2, Tomoko Toyosaki-Maeda4, Kazuo Yonenobu3 and Takahiro Ochi5
| (1) |
Department of Orthopaedic Surgery, Yukioka Hospital, 2-2-3 Ukita, Kita-ku, Osaka 530-0021, Japan |
| (2) |
Department of Internal Medicine, Yukioka Hospital, Osaka, Japan |
| (3) |
Osaka Minami Medical Center, Osaka, Japan |
| (4) |
Frontier Drug Discovery, Discovery Research Laboratories, Shionogi and Co. Ltd., Osaka, Japan |
| (5) |
Department of Rheumatology National Hospital Organization, Sagamihara National Hospital, Sagamihara, Japan |
Received:
31 August 2005
Accepted:
21 December 2005
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Abstract
To assess adrenal function with respect to the presence or absence of steroid therapy, we investigated differences in the blood levels of adrenocorticotropic hormone (ACTH) and dehydroepiandrosterone sulfate (DHEAS) in relation to steroid (prednisolone) administration in 123 patients with rheumatoid arthritis (RA). Levels of ACTH and DHEAS were significantly lower in the steroid-treated group than in the non-treated group (ACTH: 11.79pg/ml vs 27.92pg/ml) (DHEAS: 418.12 ng/ml vs 883.91ng/ml) (P < 0.0001). We observed no steroid dose-related differences in ACTH levels. However, DHEAS levels showed a slight decrease at a prednisolone dose of 2.5mg/day, with a significant decrease being observed at a dose of 5mg/day when statistical adjustments were made for age and sex (P < 0.0001). At doses of 7.5mg/day or greater, DHEAS levels were significantly lower than those for 5mg/day (P < 0.0006). These results suggest that low-dose prednisolone reduces adrenal function in patients with RA. We recommend that doses of prednisolone should be limited to 5mg/day or less in consideration of adrenal function when treating RA patients. The measurement of ACTH and DHEAS may be useful for evaluating adrenal function in patients with RA.
Key words
Adrenocorticotropic hormone (ACTH) - Dehydroepiandrosterone sulfate (DHEAS) - Rheumatoid arthritis (RA) - Steroid administration - Stress
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