A guide to understanding the steroid pathway: New insights and diagnostic implications

Greaves, Ronda F.; Jevalikar, Ganesh; Hewitt, Jacqueline; Zacharin, Margaret

doi:10.1016/j.clinbiochem.2014.07.017

Cited by 41 publications

(23 citation statements)

References 80 publications

(112 reference statements)

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“…Another advantage of the present study relative to previous studies is that we adjusted for corticosteroid dosage, and did not simply classify patients as users and nonusers. Corticosteroids are indicated for patients with autoimmune diseases, especially PS and PSA,23 and it is well known that they can increase insulin resistance and promote the development of DM 24. Research that does not adjust for steroid dose may therefore overestimate the protective effect of anti-TNF agents because patients given anti-TNF agents may require lower doses of steroids 25…”

Section: Discussionmentioning

confidence: 99%

Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

Chen

Lin

et al. 2017

TCRM

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PurposeThe aim of this study is to investigate the association between the use of disease-modifying antirheumatic drugs (DMARDs) and diabetes mellitus (DM) in patients with ankylosing spondylitis (AS), rheumatoid arthritis (RA), or psoriasis/psoriatic arthritis (PS/PSA).Patients and methodsThis retrospective cohort study used a nationwide, population-based administrative database to enroll 84,989 cases with AS, RA, or PS/PSA who initiated treatment with anti-tumor necrosis factor (anti-TNF) drugs or nonbiologic DMARDs. Multivariable analysis was used to estimate the effect of different therapies on the risk of DM.ResultsThe incidence rates of DM per 1,000 person-years were 8.3 for users of anti-TNF drugs, 13.3 for users of cyclosporine (CSA), 8.4 for users of hydroxychloroquine (HCQ), and 8.1 for users of other nonbiologic DMARDs. Compared with the users of nonbiologic DMARDs, the multivariate-adjusted hazard ratios (aHRs) for DM were significantly lower for those who used anti-TNF drugs with HCQ (aHR: 0.49, 95% confidence interval [CI]: 0.36–0.66) and those who used HCQ alone (aHR: 0.70, 95% CI: 0.63–0.78), but not for those who used anti-TNFs without HCQ (aHR: 1.23, 95% CI: 0.94–1.60) or CSA (aHR: 1.14, 95% CI: 0.77–1.70).ConclusionThe aHR for DM was lowest for patients with RA and PS/PSA who initiated treatment with an anti-TNF agent with concomitant HCQ, followed by HCQ users. Those who used anti-TNF agents without HCQ and other nonbiologic DMARDs had a similar risk of DM.

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Section: Discussionmentioning

confidence: 99%

Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

Chen

Lin

et al. 2017

TCRM

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“…In addition, Figure 2 provides the relationship of the endogenous steroid hormones and their metabolites measured in various clinical diagnostic settings. 61 As part of the differential diagnosis, abnormal hormone patterns observed in laboratory test results should include consideration of AAS administration. Case examples highlighting the pattern of low testosterone with decreased LH concentrations demonstrate the difficulties faced with the interpretation of results, as exemplified in Table 4.…”

Section: Aasmentioning

confidence: 99%

“…Endogenous steroid pathway providing a succinct overview of the relationship of steroid hormones to each other and the likely matrix for measurement (blood or urine) in the clinical diagnostic laboratory. 61 Reprinted by permission of Elsevier from A guide to understanding the steroid pathway: new insights and diagnostic implications, by Greaves et al Clinical Biochemistry, 47: 5-15, 2014 by Canadian Society of Clinical Chemists. Table 4.…”

Section: S2 -Peptide Hormones Growth Factors and Related Substancesmentioning

confidence: 99%

Doping in sport and exercise: anabolic, ergogenic, health and clinical issues

et al. 2015

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The use of doping agents is evident within competitive sport in senior and junior age groups, where they are taken by non-elite as well as elite participants. They are also taken in non-sporting contexts by individuals seeking to 'improve' their physique through an increase in muscle and/or decrease in fat mass. While attaining accurate data on the prevalence of their use has limitations, studies suggest the illicit use of doping agents by athletes and non-athletes may be 1-5% in the population and greater than 50% in some groups; with the prevalence being higher in males. There is conclusive evidence that some doping agents are anabolic and ergogenic. There is also evidence that the use of doping agents such as anabolic androgenic steroids, growth hormone and other anabolic agents, erythropoietin and stimulants conveys considerable health risks that include, but are not limited to: cardiovascular disease, diabetes, cancer, mental health issues, virilisation in females and the suppression of naturally produced androgens in males. This review will outline the anabolic, ergogenic and health impacts of selected doping agents and methods that may be used in both the sporting and physique development contexts. It also provides a brief tabulated overview of the history of doping and how doping agents may impact upon the analyses of clinical samples.

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“…Change in cortisol levels is the most accessible read-out of the human stress response. However, cortisol is embedded in complex metabolomic processes limiting the information that can be provided by a single element of the steroid pathway [ 207 ]. In this study we are planning to measure additional steroids to obtain a complete picture of the corticosteroid pathway.…”

Section: Methodsmentioning

confidence: 99%

Analyzing pathways from childhood maltreatment to internalizing symptoms and disorders in children and adolescents (AMIS): a study protocol

et al. 2015

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BackgroundEffective interventions for maltreated children are impeded by gaps in our knowledge of the etiopathogenic mechanisms leading from maltreatment to mental disorders. Although some studies have already identified individual risk factors, there is a lack of large-scale multilevel research on how psychosocial, neurobiological, and genetic factors act in concert to modulate risk of internalizing psychopathology in childhood following maltreatment. To help close this gap, we aim to delineate gender-specific pathways from maltreatment to psychological disorder/resilience. To this end, we examine the interplay of specific maltreatment characteristics and psychological, endocrine, metabolomic, and (epi-)genomic stress response patterns as well as cognitive-emotional/social processes as determinants of developmental outcome. Specifically, we will explore endocrine, metabolomic, and epigenetic mechanisms leading from maltreatment to a higher risk of depression and anxiety disorders.Methods/designFour large samples amounting to a total of N = 920 children aged 4–16 years will be assessed: Two cohorts with prior internalizing psychopathology and controls will be checked for maltreatment and two cohorts with substantiated maltreatment will be checked for internalizing (and externalizing) psychopathology. We will apply a multi-source (interview, questionnaires, official records), multi-informant strategy (parents, children, teachers) to assess maltreatment characteristics (e.g., subtypes, developmental timing, chronicity) and psychopathological symptoms, supplemented with multiple measurements of risk and protective factors and cutting-edge laboratory analyses of endocrine, steroid metabolomic and epigenetic factors. As previous assessments in the two largest samples are already available, longitudinal data will be generated within the three year study period.DiscussionOur results will lay the empirical foundation for (a) detection of early biopsychosocial markers, (b) development of screening measures, and (c) multisystem-oriented interventions in the wake of maltreatment.

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A guide to understanding the steroid pathway: New insights and diagnostic implications

Cited by 41 publications

References 80 publications

Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

Association between use of disease-modifying antirheumatic drugs and diabetes in patients with ankylosing spondylitis, rheumatoid arthritis, or psoriasis/psoriatic arthritis: a nationwide, population-based cohort study of 84,989 patients

Doping in sport and exercise: anabolic, ergogenic, health and clinical issues

Analyzing pathways from childhood maltreatment to internalizing symptoms and disorders in children and adolescents (AMIS): a study protocol

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