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Cited by 85Adrenal Hormones and DisordersRheumatoid Arthritis Research and TherapiesStress Responses and Cortisol

Low adrenal androgenic-anabolic steroids in women with rheumatoid arthritis (RA): Gas-liquid chromatographic studies of RA patients and matched normal control women indicating decreased 11-deoxy-17-ketosteroid excretion

Masi, Alfonse T., Josipovic, Dragojlo B., Jefferson, William E.·1984·Seminars in Arthritis and Rheumatism
DOI 10.1016/0049-0172(84)90005-2
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Abstract

Using GLC, multiple adrenal corticosteroid urinary metabolites, including androgenic-anabolic, glucocorticoid, pregnanediol, and pregnanetriol, were measured in eight ambulatory female RA patients and eight matched normal control subjects on baseline, ACTH-, and metyrapone-stimulation days under carefully monitored clinical research center protocol. Neither group had been treated previously with any steroid hormones. The 11-deoxy-17-KS metabolites, derived from adrenal androgenic-anabolic steroids, and comprising androsterone, etiocholanolone, and DHA, were significantly lower in RA patients on baseline (P less than .001), ACTH (P less than .005)-, and metyrapone (P less than .02)-stimulation days. To the contrary, the 11-oxy-17-KS metabolites, derived mainly from glucocorticoids, showed some lowered excretion at baseline (P less than .05), but none on ACTH- or metyrapone-stimulation. RA patients had lower tetrahydrocortisone (P less than .001) and tetrahydro-11-deoxycortisol (P less than .01) excretion at baseline, but not during ACTH- or metyrapone-stimulation, than control subjects. Pregnanetriol excretion was lower (P less than .005) in RA patients than control subjects only during ACTH-stimulation. No difference was found between groups in tetrahydrocortisol or pregnanediol excretion on any day studied. Under conditions of oral metyrapone administration (750 mg every four hours for seven doses) each control subject increased their DHA excretion, but no RA patient showed an increase over baseline excretion (P less than .02). Except for 11-deoxy-17-KS, no difference was found in the other metabolites studied during metyrapone stimulation, ie, pregnanediol, pregnanetriol, tetrahydro-11-deoxycortisol, and tetrahydrocortisol. The 24-hour oral metyrapone test provided a greater stimulus to total 11-deoxy-17-KS excretion than an eight-hour intravenous ACTH test in control and particularly RA (P less than .01) subjects even though the DHA excretion decreased in the RA groups. Our findings of lower adrenal androgenic-anabolic metabolite excretion in female RA patients than normal matched control subjects under various conditions and other supportive androgenic hormone and metabolite studies reviewed in the English reports suggest an abnormality of adrenal androgen synthesis or metabolism in RA, whether it be a primary predisposing or secondary factor in disease. The recognized female sex preponderance and age-specific patterns of occurrence of RA are consistent with adrenal androgenic function in adrenarche, adrenopause, and later changes in aging. Metabolite excretion patterns at baseline, ACTH-, and metyrapone- stimulation indicate the greatest relative

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Crossref · 10.1016/0049-0172(84)90005-2

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Authors
Masi, A. T., Josipovic, D. B., & Jefferson, W. E.
Corresponding author
Masi, Alfonse T.
ORCID
Masi, Alfonse T.
Venue
Seminars in Arthritis and Rheumatism
Publisher
Elsevier BV
Published
1984-08
Volume
14
Issue
1
Pages
1-23
ISSN
0049-0172 (ISSN-L)
DOI
10.1016/0049-0172(84)90005-2
OpenAlex
W1992630669
Cited by
85
References
103
Citations by year
2024: 1 · 2023: 1 · 2021: 2 · 2020: 1 · 2018: 1 · 2016: 2 · 2015: 5 · 2014: 2 · 2013: 1 · 2012: 1
FWCI
0.68
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Seminars in Arthritis and Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
  • Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
Keywords
rheumatoid arthritis, urinary steroid metabolites, androsterone, etiocholanolone, dehydroandrosterone, glucocorticoids, tetrahydrocortisol, pregnanediol, pregnanetriol, ACTH stimulation test, adrenal function, women
MeSH terms
Adrenal Glands, Adrenocorticotropic Hormone, Adult, Androgens, Androsterone, Arthritis, Rheumatoid, Calorimetry, Chromatography, Gas, Cortodoxone, Dehydroepiandrosterone, Etiocholanolone, Female, Glucocorticoids, Humans, Metyrapone, Middle Aged, Pregnanediol, Pregnanetriol, 17-Hydroxycorticosteroids, 17-Ketosteroids, Anabolic Agents

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