Renal clearance and daily excretion of cortisol and adrenal androgens in patients with RA and SLE

[Guest guest]

Ann Rheum Dis. 2004 Aug;63(8):961-8.

Renal clearance and daily excretion of cortisol and adrenal androgens in

patients with rheumatoid arthritis and systemic lupus erythematosus.

Straub RH, Weidler C, Demmel B, Herrmann M, Kees F, Schmidt M,

Scholmerich J, Schedel J.

Laboratory of Neuroendocrinoimmunology, Department of Internal Medicine

I, University Hospital Regensburg, D-93042 Regensburg, Germany.

rainer.straub@...

BACKGROUND: In rheumatoid arthritis (RA) and systemic lupus

erythematosus (SLE), patients demonstrate low levels of adrenal

hormones. OBJECTIVE: To investigate whether increased renal clearance

and daily excretion contribute to this phenomenon. METHODS: Thirty

patients with RA, 32 with SLE, and 54 healthy subjects (HS)

participated. Serum and urinary levels of cortisol, cortisone,

17-hydroxyprogesterone (17OHP), androstenedione, dehydroepiandrosterone

(DHEA), and DHEA sulphate (DHEAS) were measured. RESULTS: Clearance of

DHEAS and DHEA was lower in patients than in HS, and clearance of

androstenedione was somewhat higher in patients than in HS, but daily

excretion of this latter hormone was low. Clearance of cortisol,

cortisone, and 17OHP was similar between the groups. The total molar

amount per hour of excreted DHEA, DHEAS, and androstenedione was lower

in patients than HS (but similar for cortisol). Serum DHEAS levels

correlated with urinary DHEAS levels in HS and patients, whereby HS

excreted 5-10 times more of this hormone than excreted by patients. Low

serum levels of adrenal androgens and cortisol in patients as compared

with HS were confirmed, and proteinuria was not associated with changes

of measured renal parameters.

CONCLUSIONS: This study in patients with RA and SLE demonstrates that

low serum levels of adrenal androgens and cortisol are not due to

increased renal clearance and daily loss of these hormones. Decreased

adrenal production or increased conversion or conjugation to downstream

hormones are the most likely causes of inadequately low serum levels of

adrenal hormones in RA and SLE.

PMID: 15249323

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org