ACTH Clinical Trial
Official title:
Evaluation of Cortisol Resistance in Young Sedentary and Endurance-trained Men and Elderly Sedentary Men
This study proposes to examine multiple aspects of the hypothalamic-pituitary-adrenal axis in younger endurance trained and sedentary men, and in older sedentary men.
Adrenocorticotropin (ACTH) secretion is normally exquisitely regulated through endogenous
stimulation by corticotrophin-releasing hormone (CRH) and negative feedback inhibition by
cortisol, resulting in a circadian rhythm of cortisol. Recent evidence suggests that older
men, and younger men who are endurance-trained athletes, both have reduced sensitivity to
negative feedback, and perhaps increased basal levels of cortisol and ACTH. To investigate
these possibilities, we propose to examine multiple aspects of the
hypothalamic-pituitary-adrenal axis in younger endurance trained and sedentary men, and in
older sedentary men.
Subjects will collect saliva during two evenings before additional testing, and will on the
same evening collect urine for twelve hours, both for cortisol measurements. Blood samples
will be collected to evaluate the response to dexamethasone. We also will assess ACTH and
cortisol responses to medications that reduce negative inhibition of ACTH. This testing will
occur in the evening and will include administration of the glucocorticoid antagonist
mifepristone, the mineralocorticoid antagonist spironolactone, and/or a look-alike tablet, on
four occasions.
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