Aim: 

Previously, we found a relative sub-responsiveness of HPA axis to hypoglycaemia in patients with rheumatoid arthritis (RA). The aim of the present study was to assess the adrenal steroidogenesis response to a minimal ACTH test in patients with rheumatoid arthritis (RA).

Methods: 

Premenopausal female lean RA patients and matched healthy controls were examined. Minimal ACTH test (i.v. bolus of 1mg synthetic ACTH) was performed at 10:00 am with blood sampling every 15 min for 90 min to measure the plasma levels of cortisol, 17-OH-progesterone (17OHP), 4-androstenedione (ASD) and dehydroepiandrosterone (DHEA).

Results: 

ACTH administration caused a significant increase of all steroids concentrations observed in both patients and controls (p < 0.001). The responses of 17OHP and ASD, and the molar ratio of ASD: cortisol were significantly lower (p < 0.05, p < 0.01, and p < 0.05, respectively) in a subgroup of patients treated with corticoids when compared to controls.

Conclusion: 

In accord with previous study our recent results indicate a change in secretion of androgens in favour of cortisol synthesis pathway in RA patient, mainly in the subgroup receiving corticoids.

This study was supported by grants VEGA 2/6157/27 and MZ2005/20-NURCH-04.