Effect of Arginine on the Hypothalamic-Pituitary-Adrenal Axis in Individuals With and Without Vasopressin Deficiency.

Abstract

CONTEXT:

Arginine stimulates pituitary hormones, like growth hormone and vasopressin, but its effect on the hypothalamic-pituitary-adrenal (HPA) axis is unknown. Arginine may also stimulate the HPA axis, possibly through a mechanism involving vasopressin.

OBJECTIVE:

To investigate the effect of arginine on adrenocorticotropic hormone (ACTH) and cortisol in subjects with and without vasopressin deficiency.

DESIGN:

Prospective study, University Hospital Basel.

PARTICIPANTS:

38 patients with central diabetes insipidus, 58 patients with primary polydipsia, and 50 healthy controls.

INTERVENTION:

Arginine infusion with measurement of ACTH, cortisol and copeptin at baseline and 30, 45, 60, 90, and 120 minutes.

RESULTS:

We found different response patterns to arginine: in patients with diabetes insipidus (and low stimulated copeptin levels) median (interquartile range [IQR]) ACTH and cortisol increased from 22.9 (16.8, 38.7) to 36.6 (26.2, 52.1) ng/L and from 385 (266, 463) to 467 (349, 533) nmol/L, respectively. In contrast, median (IQR) ACTH and cortisol levels decreased in patients with primary polydipsia (despite high stimulated copeptin levels): ACTH from 17.3 (12.3, 23) to 14.8 (10.9, 19.8) ng/L and cortisol from 343 (262, 429) to 272 (220.8, 360.3) nmol/L; likewise, in healthy controls: ACTH from 26.5 (17.6, 35.7) to 14.8 (12.1, 22.7) ng/L and cortisol from 471 (393.3, 581.8) to 301.5 (206.5, 377.8) nmol/L.

CONCLUSION:

Diabetes insipidus is associated with increased responsiveness of ACTH/cortisol to arginine. In contrast, arginine does not stimulate the HPA axis in healthy controls or in primary polydipsia.

• Authors: Katja Bologna, Nicole Cesana-Nigro, Julie Refardt, Cornelia Imber, Deborah R Vogt, Mirjam Christ-Crain, Bettina Winzeler
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 105 Issue 7 (07 01 2020) ISSN: 1945-7197 [Electronic] United States
• PMID: 32236441 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © Crown copyright 2020.

Chemical References

• Glycopeptides
• copeptins
• Adrenocorticotropic Hormone
• Arginine
• Hydrocortisone

Topics

• Adrenocorticotropic Hormone (blood)
• Adult
• Arginine (pharmacology)
• Diabetes Insipidus, Neurogenic (blood, physiopathology)
• Female
• Glycopeptides (blood)
• Humans
• Hydrocortisone (blood)
• Hypothalamo-Hypophyseal System (drug effects, physiopathology)
• Male
• Middle Aged
• Pituitary-Adrenal System (drug effects, physiopathology)
• Polydipsia, Psychogenic (blood, physiopathology)
• Prospective Studies
• Young Adult