Normalization of ACTH and cortisol responses to ghrelin in patients cured from Cushings disease
Dragana Miljic, Mirjana Doknic, Sandra Pekic, Marko Stojanovic, Marina Djurovic & Vera Popovic
Previous studies have shown exaggerated ACTH and cortisol responses to ghrelin. Seven patients who were cured by transsphenoidal operation from CD were included in the study and tested with ghrelin (1 mcg/kg i.v.) before and six months after the operation. Their results were compared with eight healthy control subjects. Results are presented as mean±S.D. MannWhitney and Wilcoxon signed rank test were used for statistical analysis.
Before the operation, baseline ACTH (86.7±58.9 vs 24.2±16.2 ng/ml, P<0.05) and cortisol concentrations (671.1±224.3 vs 338.6±135.2 nmol/l, P<0.01) were significantly higher in patients with CD compared to control subjects. Peak ACTH (185.44±99.3 vs 59.5±41.2 ng/ml, P<0.01) and cortisol responses (1021±201 vs 610.8±170.6, P< 0.01) were also significantly higher in patients with CD, before operation, compared to controls.
After operation, baseline ACTH (from 86.7±58.9 to 21.7±19.9 ng/ml, P<0.05) and cortisol concentrations (from 671.2±224.3 to 393.7±99.5 nmol/l, P<0.05) significantly decreased as well as peak ACTH (from 185.4±99.3 to 40.5±34.7 ng/ml, P< 0.05) and cortisol responses (from 1024±201 to 603.8±147.3 nmol/l, P<0.05) to ghrelin. After the operation, baseline and peak ACTH and cortisol values in patients cured from CD were not significantly different from those observed in control subjects (P>0.05).
Normalization of ACTH and cortisol responses to ghrelin was observed, six months after the transsphenoidal adenectomy, in our patients treated for CD.