Salivary Cortisol and Cortisone do not Appear to be Useful Biomarkers for Monitoring Hydrocortisone Replacement in Addison's Disease
| Autor: | Joel A. Dave, D. Haarburger, Dirk J. Blom, J. S. Van der Walt, Miguel Lacerda, Gudmundur Johannsson, Naomi S. Levitt, Tahir S Pillay, Ian L. Ross |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Hydrocortisone Hormone Replacement Therapy Endocrinology Diabetes and Metabolism Clinical Biochemistry 030209 endocrinology & metabolism 030204 cardiovascular system & hematology Biochemistry 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Pharmacokinetics Addison Disease Interquartile range Internal medicine Hypoadrenalism medicine Humans Saliva Salivary cortisol business.industry Biochemistry (medical) Area under the curve General Medicine Middle Aged medicine.disease Cortisone Addison's disease Case-Control Studies Female business Biomarkers medicine.drug |
| Zdroj: | Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme. 48(12) |
| ISSN: | 1439-4286 |
| Popis: | Salivary cortisol has been used to monitor hydrocortisone replacement in patients with Addison’s disease (AD). Since salivary cortisol is metabolised to salivary cortisone, it may be an adjunctive analyte to assess adequacy of hydrocortisone replacement in patients with AD. We aimed to characterise the exposure of salivary cortisol and cortisone in patients and healthy controls. We measured salivary cortisol and cortisone by liquid chromatography-tandem mass spectrometry and constructed a day curve (08:00 until 24:00 h) with 16 time points in 25 AD patients taking their usual hydrocortisone dose and in 26 healthy controls. The median (interquartile range) area under the curve (AUC) for cortisol was not different for patients, compared with controls [55.63 (32.91–151.07) nmol*min*l –1 vs. 37.49 (27.41–52.00) nmol*min*l –1 ; p=0.098, respectively], whereas the peak cortisol C max was higher in patients [32.61 (5.75–146.19) nmol/l vs. 8.96 (6.96–12.23) nmol/l; p=0.013], compared with controls. The AUC for cortisone [23.65 (6.10–54.76) nmol*min*l –1 vs. 227.73 (200.10–280.52) nmol*min*l –1 ; p≤ 0.001, respectively], and peak cortisone C max was lower in patients than in controls [11.11 (2.91–35.85) nmol/l vs. 33.12 (25.97–39.95) nmol/l; p=0.002]. The AUC for salivary cortisol and salivary cortisone were not correlated with any measures of hydrocortisone dose. The time-course and AUC of salivary cortisol were similar between Addison’s patients and healthy controls. Patients had substantially lower salivary cortisone AUC, compared to healthy controls. Salivary cortisol AUC and pharmacokinetics were not related to hydrocortisone dose and thus are not likely useful markers for the adequacy of hydrocortisone replacement. |
| Databáze: | OpenAIRE |
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