Skip to main content

Advertisement

SpringerLink
Log in

Hypothalamus-pituitary-adrenal axis in central diabetes insipidus: ACTH and cortisol responsiveness to CRH administration

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

A strong relationship has been found between arginine-vasopressin (AVP) and hypotha-lamus-pituitary-adrenal axis in humans. The aim of the current study was to evaluate baseline and CRH-stimulated ACTH and F levels in patients with central diabetes insipidus (CDI), before and after replacement therapy with desamino-D-AVP (DDAVP). Twenty-five patients with CDI, and 25 sex- and age-and BMI-matched healthy subjects entered the study. A standard CRH test (measurement of plasma ACTH and serum F before and every 15 min for 2 h after the administration of 100 μg of human CRH) was performed in all subjects. In patients with CDI, CRH test were repeated after 1 week of DDAVP at standard doses. At study entry, ACTH and F levels were significantly higher in patients with CDI than in controls either at baseline (ACTH: 45.5±4.8 vs 18.5±3.3 ng/l, p<0.05; F: 375.1±55.7 vs 146.6±19.4 μg/l, p<0.05) or after CRH test considered as a peak (ACTH: 90.8±14.4 vs 42.5±7.4 ng/l, p<0.05; F: 501.6±65.7 vs 226.3± 25.6 μg/l, p<0.05) and AUC (ACTH: 3997.0±571.7 vs 2136.0±365.8 ng/l/120 min, p<0.05; F: 31489.0 ±4299.4 vs 14854.5±1541.5 μg/l/120 min, p<0.05). In patients with CDI, 1 week of replacement with DDAVP brought down ACTH (peak: 56.9±9.3 ng/l; AUC: 2390.7±480.7 ng/l/120 min) and F (peak: 310.3±39.5 μg/l; AUC: 17555.5±2008.7 μg/l/120 min) responses to CRH to normal but did not sig-nificantly modify baseline hormone levels (ACTH: 29.6±3.6 ng/l; F: 239.0±32.3 μg/l). In conclusion, CDI is associated to increased baseline ACTH and F levels and increased responsiveness of ACTH and F to CRH administration. In addition, replacement treatment with DDAVP normalized CRH-induced but not baseline ACTH and F secretion.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Gwinup G. Test for pituitary function using vasopressin. Lancet 1965, 2: 572–573.

    Article  CAS  PubMed  Google Scholar 

  2. Gwinup G. Studies on the mechanism of vasopressin-in-duced steroid secretion in man. Metabolism 1965, 14: 1282–1286.

    Article  CAS  PubMed  Google Scholar 

  3. Gwinup G., Steinberg T., King C.G., Vernikos-Danellis J. Vasopressin-induced ACTH secretion in man. J. Clin. Endocrinol. Metab. 1967, 27: 927–930.

    Article  CAS  PubMed  Google Scholar 

  4. Gillies G.E., Linton E.A., Lowry P.J. Corticotropin releasing activity of new CRF is potentiated several times by vasopressin. Nature 1982, 299: 355–357.

    Article  CAS  PubMed  Google Scholar 

  5. DeBold C.R., Sheldon W.R., DeCherney G.S. et al. Arginine vasopressin potentiates adrenocorticotropin release induced by ovine corticotropin-releasing factor. J. Clin. Invest. 1984, 73: 533–538.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Lamberts S.W.J., Verleun T., Oosterom R., De Jong F., Hackeng W.H.L. Corticotropin-releasing factor (ovine) and vasopressin exert a synergistic effect on adrenocorticotropin release in man. J. Clin. Endocrinol. Metab. 1984, 58: 298–303.

    Article  CAS  PubMed  Google Scholar 

  7. Oelkers W. Hyponatriemia and inappropriate secretion of vasopressin (antidiuretic hormone) in patients with hypopituitarism. N. Engl. J. Med. 1989, 321: 492–496.

    Article  CAS  PubMed  Google Scholar 

  8. Wakui H., Nishinari T., Nishimura S., Endo Y., Nakamoto Y., Miura A.B. Inappropriate secretion of antidiuretic hormone in isolated adrenocorticotropin deficiency. Am. J. Med. Sci. 1991, 301: 319–321.

    Article  CAS  PubMed  Google Scholar 

  9. Wittert G.A., Crock P.A., Donald R.A. et al. Arginine va-sopressin in Cushing’s disease. Lancet 1990, 335: 991–994.

    Article  CAS  PubMed  Google Scholar 

  10. Nussey S.S., Page S.R., Peterson D.B. et al. Corticotropin releasing hormone (CRH 1-41) stimulates the secretion of adrenocorticotrophin, vasopressin and oxytocin but not adrenocorticotrophin precursors: evidence from pet-rosal sinus sampling in man. Clin. Endocrinol. 1991, 34: 51–56.

    Article  CAS  Google Scholar 

  11. Colao A., Ferone D., Di Sarno A. et al. Vasopressin levels in Cushing’s disease: inferior petrosal sinus assay, response to corticotrophin-releasing hormone and comparison with patients without Cushing’s disease. Clin. Endocrinol. 1996, 45: 157–166.

    Article  CAS  Google Scholar 

  12. Colao A., Pivonello R., Ferone D. et al. Effect of corti-cotropin-releasing hormone on arginine vasopressin and atrial natriuretic factor in patients with Cushing’s disease. Clin. Endocrinol. 1998, 49: 77–84.

    Article  CAS  Google Scholar 

  13. Pivonello R., Colao A., Di Somma C. et al. Impairment of bone status in patients with central diabetes insipidus. J. Clin. Endocrinol. Metab. 1998, 83: 2275–2280.

    CAS  PubMed  Google Scholar 

  14. Pivonello R., Faggiano A., Di Somma C. et al. Effect of short-term treatment with alendronate on bone density and bone markers in patients with central diabetes in-sipidus. J. Clin. Endocrinol. Metab. 1999, 84: 2349–2352.

    Article  CAS  PubMed  Google Scholar 

  15. Pivonello R., Faggiano A., Arrichiello P. et al. Central diabetes insipidus and heart: effect of acute arginine vaso-pressin deficiency and replacement treatment with desmo-pressin on cardiac performance. Clin. Endocrinol. 2001, 54: 97–106.

    Article  CAS  Google Scholar 

  16. Mazza E., Goffi S., Barchi P. et al. Enhanced adrenocorti-cotropic hormone and cortisol responses to corticotrophin-releasing hormone in central idiopathic diabetes insipidus. Eur. J. Endocrinol. 1994, 130: 121–124.

    Article  CAS  PubMed  Google Scholar 

  17. Elias L.L.K., Antunes-Rodrigues J., Elias P.C.L., Moreira A.C. Effect of plasma osmolality on pituitary-adrenal responses to corticotropin-releasing hormone and atrial natriuretic peptide changes in central diabetes insipidus. J. Clin. Endocrinol. Metab. 1997, 82: 1243–1247.

    CAS  PubMed  Google Scholar 

  18. Carraro A., Giusti M., Porcella P., Sessarego P., Giordano G. Differing responses of cortisol to oCRF during endonasal and oral treatment with DDAVP. Eur. J. Clin. Invest. 1994, 24: 459–462.

    Article  CAS  PubMed  Google Scholar 

  19. Zacharieva S., Andreeva M., Orbetzova M. et al. Effects of corticotropin-releasing hormone on ACTH, cortisol and 13, 14-dihydro-15-keto prostaglandin E2 in patients with diabetes insipidus before and after captopril treatment. Prostaglandins Leukot. Essent. Fatty Acids 1996, 54: 433–437.

    Article  CAS  Google Scholar 

  20. Robertson G.L. Differential diagnosis of polyuria. Annu. Rev. Med. 1988, 39: 425–442.

    Article  CAS  PubMed  Google Scholar 

  21. Zerbe R.I., Robertson G.L. A comparison of plasma vaso-pressin measurements with standard indirect test in the differential diagnosis of polyuria. N. Engl. J. Med. 1981, 305: 1539–1549.

    Article  CAS  PubMed  Google Scholar 

  22. Blotner H. Primary and idiopathic diabetes insipidus: a system disease. Metabolism 1958, 7: 191–200.

    CAS  PubMed  Google Scholar 

  23. Recht L.D., Hoffman D.L., Haldar J., Silverman A.J., Zimmerman E. Vasopressin concentrations in hypophyseal portal plasma: insignificant reduction following removal of the posterior pituitary gland. Neuroendocrinology 1981, 33: 88–90.

    Article  PubMed  Google Scholar 

  24. Lechan R.M. Neuroendocrinology of pituitary hormone regulation. Endocrinol. Metab. Clin. North Am. 1987, 16: 475–501.

    CAS  PubMed  Google Scholar 

  25. Owens M.J., Nemeroff C.B. Physiology and pharmacology of corticotropin-releasing factor. Pharmacol. Rev. 1991, 43: 425–473.

    CAS  PubMed  Google Scholar 

  26. Orth D.N. Corticotropin-releasing hormone in humans. Endocr. Rev. 1992, 13: 164–191.

    CAS  PubMed  Google Scholar 

  27. Antaraki A., Rangou D., Chlouverakis C. The renin-aldos-terone axis in patients with diabetes insipidus. Clin. Endocrinol. 1994, 40: 505–510.

    Article  CAS  Google Scholar 

  28. Spinedi E., Negro-Vilar A. Angiotensin II and ACTH release: site of action and potency relative to corticotropin releasing factor and vasopressin. Neuroendocrinology 1983, 37: 446–453.

    Article  CAS  PubMed  Google Scholar 

  29. Singh A., Petrides J.S., Gold P.W., Chrousos G.P., Deuster P.A. Differential hypothalamic-pituitary-adrenal axis reactivity to psychological and physical stress. J. Clin. Endocrinol. Metab. 1999, 84: 1944–1948.

    CAS  PubMed  Google Scholar 

  30. Holmes M.C., Catt K.J., Aguilera G. Involvement of vaso-pressin in the down-regulation of pituitary corticotropin-releasing factor receptors after adrenalectomy. Endocrinology 1987, 121: 2093–2098.

    Article  CAS  PubMed  Google Scholar 

  31. Kopin I.J. Definition of stress and sympathetic neuronal responses. Ann. N.Y. Acad. Sci. 1995, 771: 19–30.

    Article  CAS  PubMed  Google Scholar 

  32. Kline R.L., Patel K.L., Mercer P.F. Enhanced noradrenegic activity in the kidney of Brattleboro rats with diabetes insipidus. Am. J. Physiol. 1986, 250: R567–R572.

    CAS  PubMed  Google Scholar 

  33. Axelrod J., Reisine T.D. Stress hormones: their interaction and regulation. Science 1984, 224: 452–459.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Oncologia e Endocrinologia Molecolare e Clinica, “Federico II” Università di Napoli, Via Sergio Pansini 5, 80131, Napoli, Italia

    R. Pivonello, A. Faggiano, M. Filippella, C. Di Somma, M. C. De Martino, M. Gaccione, G. Lombardi &  Annamaria Colao

Authors
  1. R. Pivonello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Faggiano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Filippella
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Di Somma
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. M. C. De Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Gaccione
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G. Lombardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Annamaria Colao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Annamaria Colao.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pivonello, R., Faggiano, A., Filippella, M. et al. Hypothalamus-pituitary-adrenal axis in central diabetes insipidus: ACTH and cortisol responsiveness to CRH administration. J Endocrinol Invest 25, 932–937 (2002). https://doi.org/10.1007/BF03344064

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03344064

Key-words

Search

Navigation