Effect of calcium on adrenocortical secretion

The authors investigated the effect of calcium on the basal cortisol secretion and on the adrenocortical secretory reserve, the indicator of which is the so-called ACTH stimulation test. They revealed that during acute hypercalcaemia there is a significant increase of the basal cortisol secretion. The adrenocortical secretory reserve is significantly reduced during hypercalcaemia, this being manifested by a smaller rise of cortisolaemia after ACTH. The Synacthen test repeated after a 48-hour interval is fully reproducible under normocalcaemia. The basal values and the response to Synacthen do not differ from the control examination. The stimulatory action of calcium can be explained indirectly via other humoral factors, the production of which is enhanced by calcium but also the function of calcium which acts as the so-called "second messenger" in steroidogenesis. Calcium has, however, probably also a direct corticotropic effect, resembling that of ACTH.