Longitudinal Monitoring of Hair Cortisol Using Liquid Chromatography-Mass Spectrometry to Prevent Hypercortisolism in Patients Undergoing Glucocorticoid Replacement Therapy.

Autor:	Kostolanská K; Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Šiprová H; Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic., Bartečků E; Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic ; and., Juřica J; Department of Pharmacology and Toxicology, Pharmaceutical Faculty, Faculty of Medicine, Masaryk University, Masaryk Memorial Cancer Institute, Brno, Czech Republic., Řiháček I; Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic., Táborská E; Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic., Souček M; Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic., Peš O; Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Jazyk:	angličtina
Zdroj:	Therapeutic drug monitoring [Ther Drug Monit] 2022 Jun 01; Vol. 44 (3), pp. 438-447.
DOI:	10.1097/FTD.0000000000000946
Abstrakt:	Objective: Currently available methods for endogenous cortisol monitoring in patients with hormonal insufficiency rely on measurements of plasma levels only at a single time point; thus, any kind of chronic exposure to cortisol is challenging to evaluate because it requires collecting samples at different time points. Hair cortisol levels acquired longitudinally better reflected chronic exposure (both cortisol synthesis and deposition) and may significantly contribute to better outcomes in glucocorticoid replacement therapies. Design: Twenty-two patients on cortisol substitution therapy were monitored for plasma, urinary, and hair cortisol levels for 18 months to determine whether hair cortisol may serve as a monitoring option for therapy setting and adjustment. Methods: Plasma and urinary cortisol levels were measured using standardized immunoassay methods, and segmented (∼1 cm) hair cortisol levels were monitored by liquid chromatography coupled to mass spectrometry. A log-normal model of the changes over time was proposed, and Bayesian statistics were used to compare plasma, urinary, and hair cortisol levels over 18 months. Results and Conclusions: Hair cortisol levels decreased over time in patients undergoing substitutional therapy. The residual variance of hair cortisol in comparison to plasma or urinary cortisol levels was much lower. Thus, longitudinal monitoring of hair cortisol levels could prove beneficial as a noninvasive tool to reduce the risk of overdosing and improve the overall patient health. Competing Interests: E. Bartečků declares a commercial relationship with Angelini S.p.A. in the form of honoraria. J. Juřica claims a commercial relationship with Krka, Leram, and Angelini in honoraria for consultations and lecturing. Other authors declare that they do not have any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu