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Markers of Adrenal Function Correlate With Outcomes of Patients With Community-Acquired Pneumonia: Presented at ECE By Karen Dente PRAGUE, Czech Republic -- April 29, 2010 -- Adrenal function appears to be an important indicator for outcome and survival in patients with community-acquired pneumonia (CAP), researchers said here at the 12th European Congress of Endocrinology (ECE). "We assessed the prognostic value of DHEA [dehydroepiandrosterone] and DHEAS [dehydroepiandrosterone sulfate], and of cortisol/DHEA and cortisol/DHEAS ratios in patients with community-acquired pneumonia," said Claudine Blum, MD, Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Basel, Basel, Switzerland, on April 25. Rapidly being able to stratify patients with CAP according to their risk is an unmet clinical need and the cortisol to DHEA ratio was put forward as a prognostic marker for sepsis. Community-acquired pneumonia with sepsis can quickly advance to a serious condition in these patients. All 181 patients recruited for the study had confirmed CAP. Linear regression analysis calculated using a model adjusted for age and gender to assess hormone associations with the pneumonia severity index (PSI) showed that total cortisol, DHEAS, and DHEA were all positively associated with CAP severity (P < .001 for all hormones). Logistic regression analysis adjusting for age and gender to assess associations of hormones and in-hospital mortality showed that cortisol (P < .001) and DHEA (P < .001) were predictors of mortality. DHEAS was associated with in-hospital mortality to a lesser extent than DHEAS (P = .07) in comparison. The ratios of cortisol to DHEA and DHEAS and of DHEA to DHEAS were not associated with the PSI and were not predictors of survival. "The hormone levels of cortisol, DHEA, and DHEAS correlate with severity and survival in CAP," says Dr. Blum. However, the different ratios of these hormones to each other do not predict outcome. The prognostic accuracy of DHEA and DHEAS is comparable to the PSI and cortisol alone remains the best prognostic marker for outcome. "Therefore not cortisol alone, but adrenal function in general and its possible exhaustion in severe pneumonia is an important factor for outcome and survival," the authors concluded. [Presentation title: Serum Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate as Markers of Disease Severity in Community-Acquired Pneumonia. Poster 14] E-mail this page to a friend or colleague! To print, use this version