Higher free serum cortisol is associated with worse survival in acute variceal bleeding because of cirrhosis

Autor:	Konstantinos Zisimopoulos, Eleni Jelastopulu, Georgios Theocharis, Elias A. Kouroumalis, Christos Triantos, Apostolos Sapountzis, Konstantinos Thomopoulos, Dimitrios Samonakis, Maria Kalafateli, Nikolaos Papiamonis, Andrew K. Burroughs, Chryssoula Labropoulou-Karatza, Vasiliki Nikolopoulou, Venetsanea Kyriazopoulou, Marina Michalaki
Rok vydání:	2014
Předmět:	Liver Cirrhosis Male Time Factors Cirrhosis Hydrocortisone Severity of Illness Index Gastroenterology Liver Function Tests Risk Factors London Prospective Studies Prospective cohort study Aged 80 and over Greece biology Liver Neoplasms Area under the curve Middle Aged Prognosis Up-Regulation Area Under Curve Hepatocellular carcinoma Acute Disease Corticosteroid Female Gastrointestinal Hemorrhage Adult medicine.medical_specialty Carcinoma Hepatocellular Globulin medicine.drug_class Serum Albumin Human Esophageal and Gastric Varices Predictive Value of Tests Internal medicine Severity of illness medicine Adrenal insufficiency Humans Serum Albumin Aged Proportional Hazards Models Chi-Square Distribution Hepatology business.industry medicine.disease Surgery Logistic Models ROC Curve Multivariate Analysis Adrenal Cortex biology.protein Carrier Proteins business Biomarkers
Zdroj:	European Journal of Gastroenterology & Hepatology. 26:1125-1132
ISSN:	0954-691X
DOI:	10.1097/meg.0000000000000158
Popis:	BACKGROUND AND AIMS Critical illness-related corticosteroid insufficiency has been reported in acute variceal bleeding (AVB). In cirrhosis, free serum cortisol (FC) is considered optimal to assess adrenal function. Salivary cortisol (SC) is considered a surrogate for FC. We evaluated FC and its prognostic role in AVB. METHODS Total serum cortisol, SC, cortisol-binding globulin, and FC (Coolens' formula) were evaluated in AVB (n=38) and in stable cirrhosis (CC) (n=31). A Cox proportional hazards model was evaluated for 6-week survival. RESULTS In AVB, the median FC and SC levels were higher with worse liver dysfunction [Child-Pugh (CP) A/B/C: 1.59/2.62/3.26 μg/dl, P=0.019; CPA/B/C: 0.48/0.897/1.81 μg/ml, P
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ca41fc687fdb1ef6950b75f1ba832a68 https://doi.org/10.1097/meg.0000000000000158 Zobrazit plný text záznamu