Evaluation of Feasibility for a Case-Control Study of Adrenal Androgen Production in Postmenopausal Women With Breast Cancer

摘要

Postmenopausal women with elevated serum estrogens and androgens are at an increased risk of breast cancer. Dehydroepiandrosterone sulfate (DHEAS) is secreted only by the adrenals, and elevated serum DHEAS levels in postmenopausal women who develop breast cancer suggest increased adrenal androgen production. The objective of this pilot study was to evaluate variation in responsiveness of adrenal hormones to ACTH stimulation in healthy postmenopausal women. We also evaluated variation in natural killer cell cytotoxicity in response to ACTH. ACTH stimulation was accomplished by infusing a physiologic dose of synthetic ACTH over one hour following overnight adrenal suppression with dexamethasone. Results indicate considerable variation in response of serum progesterone, cortisol, DHEA, and androstenedione following ACTH stimulation. Other hormones measured and natural killer cell cytotoxictiy did not change significantly after ACTH. Future analyses will attempt to identify determinants of variation in response of progesterone, cortisol and adrenal androgens to ACTH stimulation.