Background: Sucrose intake has been shown to normalize the disturbed neuroendocrine stress response in adrenalectomized rats. These previous data indicate a compensatory effect of energy supply on altered parameters in chronic cortisol deficiency. Thus, we hypothesized that glucose infusion may have similar beneficial effects in patients with Addisons disease.
Methods: We examined 10 patients with primary adrenal insufficiency who discontinued their hydrocortisone substitution and 10 matched healthy controls in two randomized conditions. Subjects received either an intravenous glucose application (0.75 g glucose/kg for 2.5 h) or a sodium chloride infusion. We assessed parameters of cognitive function (short-term memory, selective attention) as well as symptom scores and measured concentrations of the relevant hormones in this context (ACTH, cortisol, catecholamines, GH, glucagon).
Results: In the Addison group, recall of emotional words was enhanced by glucose infusion, whereas recall of neutral words was impaired. Glucose infusion did not influence word recall in the control group. Selective attention and symptom scores were not affected by glucose infusion as compared to placebo, but selective attention was generally lower in patients than in controls under both conditions. Concentrations of ACTH, cortisol, GH, and glucagon showed no significant difference between conditions in both groups.
Conclusion: Our data do not confirm a compensating effect of glucose infusion on neuroendocrine parameters in chronic cortisol deficiency in humans. However, glucose affected short-term memory in a differential way with improvements in the emotional task while neutral memory was impaired. Since emotional memory is primarily amygdala-dependent while neutral memory processing is rather assigned to the hippocampus, one could speculate that glucose application may cause differential effects on these brain areas in patients with Addisons disease.
03 - 07 May 2008
European Society of Endocrinology