[Adrenal function in patients with chronic obstructive lung diseases].

Area of Science:

• Endocrinology
• Pulmonology
• Physiology

Background:

• Chronic obstructive pulmonary disease (COPD) is often associated with hypoxemia.
• The adrenal cortex plays a crucial role in stress response and hormone regulation.
• Understanding the interaction between hypoxemia and the hypothalamic-pituitary-adrenal (HPA) axis is vital for managing COPD patients.

Purpose of the Study:

• To investigate the relationship between hypoxemia in COPD patients and adrenal cortex function.
• To assess the impact of hypoxemia on hydrocortisone, ACTH, and 17-hydroxycorticosteroids levels.
• To evaluate the effect of oxygen therapy on these hormonal parameters in COPD patients.

Main Methods:

• Studied 22 COPD patients and 12 healthy controls.
• Measured blood hydrocortisone and ACTH levels.
• Assessed 17-hydroxycorticosteroids urine excretion.
• Performed suprarenal function stimulation tests using Synacthen.
• Monitored hormonal levels before and after comprehensive treatment including oxygen therapy.

Main Results:

• COPD patients with hypoxemia exhibited significantly higher hydrocortisone and 17-hydroxycorticosteroids levels.
• Elevated ACTH plasma levels and a strong response to Synacthen stimulation were observed in COPD patients.
• Following oxygen therapy, hydrocortisone, ACTH, and 17-hydroxycorticosteroids levels decreased to those of healthy individuals.

Conclusions:

• Hypoxemia in COPD patients reliably stimulates the adrenal cortex, leading to increased hormone secretion.
• The HPA axis is activated in response to hypoxemia in COPD.
• Oxygen therapy effectively mitigates the stimulatory effect of hypoxemia on the adrenal cortex in COPD patients.