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

D Dimitrov, I Krŭstev, Kh Marinov

    Vutreshni Bolesti
    |January 1, 1987
    PubMed
    Summary

    Hypoxemia in chronic obstructive pulmonary disease (COPD) patients stimulates the adrenal cortex, increasing hydrocortisone and ACTH levels. Treatment with oxygen therapy normalized these hormone levels, indicating hypoxemia

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    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.

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  • 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.