Hormonal Axis Regulation Linked to Interstitial Cystitis Symptomatology

NEW YORK (Reuters Health) Mar 29 – Dysregulation of the hypothalamic-pituitary-adrenal axis may to be linked to interstitial cystitis symptomatology, according to a report published in the March issue of The Journal of Urology.

Dr. Susan K. Lutgendorf, from the University of Iowa in Iowa City, and colleagues measured salivary and urinary cortisol levels in 48 patients with interstitial cystitis and in 35 healthy age-matched controls. Urinary levels were derived from 24-hour samples. Salivary samples were collected from a subset of 31 patients over a period of 3 days at 7 AM to 8 AM, 4 PM to 5 PM, and 9 PM to 10 PM.

Average salivary or urinary cortisol levels were similar in both groups, the authors note. In the cystitis patient group, however, higher morning cortisol levels were linked to less pain, while higher urinary free cortisol levels were tied to less overall symptomatology (p < 0.05). This held true even after controlling for the presence of comorbid conditions known to be affected by the hypothalamic-pituitary-adrenal axis.

Patients with morning cortisol levels of less than 12.5 nmol/L were nearly 13 times more likely to complain of high urinary urgency than those with higher values, the researchers state.

“These findings imply that regulation of the hypothalamic-pituitary-adrenal axis may be associated with interstitial cystitis symptomatology and there may be different diurnal hypothalamic-pituitary-adrenal patterns in patients with interstitial cystitis who do and do not have comorbid conditions,” the authors conclude.

If these results are confirmed, they could lead to interventions such as glucocorticoids for patients with low morning cortisol levels, Dr. Lutgendorf’s team notes.

J Urol 2002;167:1338-1343.

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