Document Detail

Corticotropin and cortisol response to maximal exercise testing in central diabetes insipidus.
MedLine Citation:
PMID:  17250506     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: It is known that arginine vasopressin (AVP) has a stimulatory effect on corticotropin (adrenocorticotropic hormone; ACTH) and cortisol secretion especially during stress. The present study was designed to investigate the effect of stress on ACTH and cortisol levels in patients with central diabetes insipidus (DI) with endogenous AVP deficiency receiving AVP therapy, and to determine whether these children need steroid replacement during stress. METHODS: Seven patients with a median age of 12 years (range 7-13 years) with idiopathic central DI on appropriate Desmopressin (DDAVP) therapy (group 1) and seven healthy controls with a median age of 15 years (range 13-20 years; group 2) were included in the study. Acute stress was produced in all children by treadmill exercise, assessed by maximal oxygen consumption and heart rate. ACTH and cortisol levels were determined before and after exercise. RESULTS: In group 1, median ACTH level after exercise (28.3 pg/mL) was not different from the median value (24.0 pg/mL) before exercise. However, median cortisol level (10.5 microg/dL) was significantly increased (14.9 microg/dL; P < 0.05) with exercise. In group 2, cortisol (median 9.3 microg/dL) and ACTH levels (median 6.3 pg/mL) were significantly increased after exercise (15 mug/dL and 13.6 pg/mL, respectively; P < 0.05). There was no significant difference between the groups with respect to cortisol levels before and after exercise, but the stimulated ACTH levels after exercise were higher in patients with DI than in the controls (P < 0.05). A positive correlation was observed between total daily DDAVP dose and cortisol level after exercise (r(s)= 0.786, P < 0.05). CONCLUSIONS: Cortisol response during acute stress is normal in children with DI and these patients do not need extra steroid treatment during stress. In contrast, the normal cortisol response obtained by increased ACTH levels in these patients indicates an increased sensitivity of corticotroph cells.
Firdevs Bas; Feyza Darendeliler; Burak Tatli; Mehmet Unal; Abidin Kayserilioglu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  49     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-25     Completed Date:  2007-03-27     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  53-7     Citation Subset:  IM    
Pediatric Endocrinology Unit, Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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MeSH Terms
Adrenocorticotropic Hormone / blood*
Antidiuretic Agents / administration & dosage
Deamino Arginine Vasopressin / administration & dosage
Diabetes Insipidus, Neurogenic / blood*
Exercise / physiology*
Exercise Test
Hydrocortisone / blood*
Reg. No./Substance:
0/Antidiuretic Agents; 16679-58-6/Deamino Arginine Vasopressin; 50-23-7/Hydrocortisone; 9002-60-2/Adrenocorticotropic Hormone

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