Depressive disorder as possible risk factor of osteoporosis.

Hypothalamo-pituitary-adrenal (HPA) axis is a very complicated control system playing an important role in stress reaction, where glucocorticoids suppress the autonomic (vegetative), endocrine, immunologic and psychic responses to stressful stimuli. We described the marked clinical, physiological, and biochemical connection between osteoporosis and major depressive disorder (MDD). Both conditions are associated with a hyperactive HPA axis and LC/NE system, and hence with increased CRH, cortisol, and catecholamine secretion. There are numerous states or diseases associated with osteoporosis and we were looking for a hypercorticism value as a one of these. Some recent studies demonstrated that earlier history of MDD was associated with marked osteoporosis. In MDD there are two well-documented biochemical abnormalities: hypercortisolism and its resistance to dexamethasone suppression. The present study included 31 MDD patients (19 males and 12 females, mean age 37 +/- 1.3, age range 29-41 years), and 17 healthy male volunteers (mean age 39 +/- 1.6, age range 34-45 years). In each of our patients 24-hour urinary free cortisol, serum cortisol level at 8 a.m. and 5 p.m., cortisol in dexamethasone suppression test and bone mineral density were measured. We have, therefore, analyzed a group of young men and women with normal menstrual cycles, who were without signs of osteoporosis in the beginning, and who received anti-depressive therapy for many years. Analysis showed that increased levels of cortisol and the occurrence of osteoporosis, that developed as the result of elevated cortisol level. For our workshop we used nonparametric rang-correlation with Spearman's rho = -0.805, with statistic significant at the 0.01 level (2-tailed). Patients under long-term history of depression could develop a very stronger type of osteoporosis i.e. it is before known that the patients with untreated Cushing syndrome developed hard osteoporosis.

Comparison of the postoperative fibrinogen, alpha-1-antitrypsin and alpha-2- macroglobulin concentrations in the blood of wounded soldiers of Croatian Army and peacetime injured civilians.

In 10 wounded Croatian Army soldiers and in 10 civilians with accidental musculosceletal traumatisation, blood concentrations of the 3 acute phase proteins: fibrinogen, alpha-1-antitrypsin and alpha-2-macroglobulin on the 1st, 5th and 10th postoperative day were assessed. On the 5th day after injury, increased concentrations of all 3 acute phase proteins (APP) were found in all patients. The rise of the fibrinogen concentrations in the wounded soldiers was the steepest. On the 10th day after wounding, fibrinogen concentrations in the gorup of wounded soldiers were significantly lower than those in the group of injured civilians. On the 10th day after wounding there were no differences between the 2 groups in the concentrations of alpha-1-antitrypsin and of alpha-2-macroglobulin. The lower fibrinogen concentrations in the wounded soldiers could be explained by the modulation of the general reactivity of the organism to injury, proposed by Woloski, which is induced by stress and microtrauma on battlefield before the wounding.

The effects of cortisol, 11-epicortisol, and lysine vasopressin on DNA and RNA synthesis in isolated human adrenocorticotropic hormone-secreting pituitary tumor cells.

The effects of cortisol, its steric analog 11-epicortisol, and lysine vasopressin (LVP) on DNA and RNA synthesis in isolated adrenocorticotropic hormone-secreting human pituitary tumor cells obtained by transsphenoidal surgery were studied using [3H]thymidine incorporation in DNA and [3H]uridine in RNA. Cortisol suppressed RNA and, to a greater extent, DNA synthesis in these cells. This could explain the slow growth of pituitary tumors in patients with Cushing's disease and the rapid growth of Nelson's pituitary tumors after bilateral adrenalectomy. 11-Epicortisol also suppressed RNA synthesis, but it had a stimulatory effect on DNA synthesis, which indicates a high specificity of glucocorticoid receptors. When applied together with cortisol, 11-epicortisol antagonized the suppressive effects of cortisol on DNA synthesis. Although LVP stimulated RNA synthesis, it suppressed DNA synthesis in most of the tumor cells.

Plasma gonadotropin (LH and FSH) concentrations in repubertal and pubertal children upon stimulation by LH-releasing hormone.

The simultaneous determination of LH and FSH were carried out in a single plasma sample by double antibody radioimmunoassays in a total of 26 prepubertal and pubertal children. The blood samples were taken before and after i.v. application of 25 mug synthetic LH-RH. Plasma LH and FSH concentrations found in prepubertal boys and girls at beginning of the test and at the time of maximum response were compared with those measured in pubertal boys and girls. The mean basal levels of LH and FSH are in group I (8 prepubertal girls): LH 0.6+/-0.7 (SD) mIU/ml, FSH 1.5+/-0.8 mIU/ml; in group II (6 prepubertal boys): LH 1.8+/-1.0 mIU/ml, FSH 2.0+/-0.8 mIU/ml; in group III (6 pubertal girls): LH 4.1+/-2.0 mIU/ml, FSH 4.7+/-2.8 mIU/ml; in group IV (6 pubertal boys): LH 3.5+/-2.3 mIU/ml, FSH2.0+/-1.2 mIU/ml. The mean maximum response of LH and FSH after stimulation are in group I: LH 4.1+/-2.3 mIU/ml, FSH 11.7+/-3.7 mIU/ml; in group II: LH 4.2+/-1.0 mIU/ml, FSH 6.0+/-1.1 mIU/ml; in group III: LH 19.7+/-10.6 mIU/ml, FSH 12.8+/-5.7 mIU/ml; in group IV: LH 13.4+/-5.7 mIU/ml, FSH 3.8+/-0.9 mIU/ml. It is suggested that without stimulation of the pituitary with LH-RH, plasma LH and FSH levels are not reliable parameters to test the pituitary gonadotropin reserve.