Endocrine Abstracts (2009) 20 P10

The cortisone to cortisol conversion in autoimmune Type 1 diabetes

Katerina Simunkova1, Lubomir Kriz1, Martin Hill1, Jana Vrbíková1, Richard Hampl1, Vaclav Zamrazil1,2, Denisa Janickova1,2 & Karel Vondra1

1Institute of Endocrinology, Prague, Czech Republic; 2University hospital Motol, Prague, Czech Republic.

The aim of the study was to obtain data about peripheral metabolism of cortisol.

We compared diabetics with low response (LR), and with normal response (NR) during low dose ACTH test, and a control group (C).

Twelve diabetics were investigated; LR (n=6), NR (n=6), age 44±10 year (mean±S.D.), age at diagnosis of DM1 28.5±10 year, disease duration 15±8 year, BMI 24.5±2.7 kg/cm2, HbA1c 7.2±1.2%. The control group had six healthy subjects; age 27±6 year, BMI 21.7±2.3 kg/cm2. Neither group showed any clinical signs of adrenal disorders and adrenal autoimmunity.

The study was approved by the local Ethical Committee.

At 23:00 on day 1, subjects were given 1 mg dexametasone orally. The following morning, cortisone acetate (25 mg) was administered orally. Serum cortisol (F) and cortisone (E) were then measured at 30 and 60 min intervals, respectively, for 240 min.

In diabetics the initial increase of F was delayed compared to C; the maximum was observed at 90th and 120th min (in C at 60th min). The following decrease of F was much slower in diabetics than in C but the levels of F in this phase were significantly higher then in C (P<0.05). When we compared LR to NR patients, the initial increase of F was delayed till 150th min in NR contrary to 120th min in LR. After that the levels of F in both groups decreased, but the concentrations of F were significantly higher in NR.

In conclusion, we found distinct difference in cortisone to cortisol conversion between diabetics Type 1 and controls. These result may contribute to better understanding of tissue glucocorticoid metabolism in diabetics Type 1 with latent adrenal insuficiency.

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