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People that are particularly sensitive to stress hormones also exhibit markers that suggest they are at greater risk of developing cardiovascular disease, according to research presented at the 59th Annual European Society for Paediatric Endocrinology Meeting. The study aimed to create a test that could differentiate between stress hormone sensitive and resistant people, to help clinicians better determine therapeutic outcomes and minimize adverse effects in those requiring glucocorticoid treatment. Interestingly, the protein profile associated with glucocorticoid sensitivity included increased risk markers of stress-related disorders such as stroke and heart attack, and may point to new possibilities for diagnostics or therapy in these areas.

In this study, Dr. Nicolas Nicolaides and colleagues in Athens, Greece, investigated whether a set of proteins could be identified that would distinguish between GC sensitive and resistant people. 101 healthy volunteers were given a low dose of the GC, dexamethasone, then ranked from the most sensitive to most resistant, based on their blood cortisol levels the following morning. Samples from the top and bottom 10% were then analyzed using liquid chromatography mass spectrometry to identify differences in the protein profile between these groups. The sensitive group had 110 upregulated and 66 downregulated proteins compared with the resistant group. Of the upregulated proteins in the sensitive group, several were associated with enhanced blood clotting, amyloid plaque formation in Alzheimer's disease and immune function.

Dr. Nicolaides says, "Our findings show, for the first time, how increased glucocorticoid sensitivity may be associated with stress-related disorders, including myocardial and brain infarctions, which could lead to new therapeutic interventions. This was a small, study, so further, larger studies are needed to confirm the differences observed between the glucocorticoid-sensitive and resistant people."

This study was part of a larger project, involving genetic and metabolic analyzes in healthy subjects with differences in tissue sensitivity to glucocorticoids. The team now plan to perform larger studies to confirm these findings and develop a signature profile for identifying these patient groups, which may also have increased susceptibility to stress-related disorders.

Dr. Nicolaides says, "We speculate that if the most glucocorticoid sensitive people are exposed to excessive or prolonged stress, the resultant increased blood cell activation could predispose them to clot formation in the heart and brain, leading to heart attacks or strokes. We could potentially identify those at more risk and in need of stress management."