ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
1Federal University of Minas Gerais, Brazil; 2Hermes Pardini – Aimorés, Brazil; 3McGovern Medical School, Houston, United States
Introduction: Increased plasma levels of interleukin-6 (IL-6) in response to acute hypoglycemia have been well documented. Counter-regulatory hormones are likely to play a role in this inflammatory response.
Objective: To study the interaction between IL-6 and counter-regulatory hormones during hypoglycemic stress.
Methods: We conducted an exploratory single center study involving 23 patients (mean age = 34.15 ± 8.87 years, n = 12 women) undergoing insulin tolerance test (ITT) for suspected pituitary dysfunction. Procedure-related symptoms of anxiety and hypoglycemia were measured using a standardized questionnaire. Blood levels of IL-6, adrenocorticotrophic (ACTH), adrenaline, noradrenaline, growth hormone (GH), prolactin and serum and salivary cortisol were determined throughout the ITT.
Results: Insulin-induced hypoglycemia was safely achieved in all subjects and elicited a significant dynamic response of ACTH, adrenaline, noradrenaline, GH, prolactin and serum and salivary cortisol (P < 0.001 for all variables). IL-6 plasma levels significantly increased after hypoglycemia (P < 0.001). The increase of plasma IL-6 levels during hypoglycemia correlated with the increase of serum cortisol (rs = 0.46; P = 0.022), salivary cortisol (rs = 0.52; P = 0.021), plasma ACTH (rs = 0.47; P = 0.023) and anxiety symptoms (rs = 0.441; P = 0.004).
Conclusion: Hypoglycemic stress-induced IL-6 increase is associated with the activation of the hypothalamic-pituitary-adrenal axis, reinforcing the concept that inflammatory response to stress may be regarded as a component of a broader counter-regulatory response.