Improved salivary cortisol rhythm with dual-release hydrocortisone
| العنوان: | Improved salivary cortisol rhythm with dual-release hydrocortisone |
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| المؤلفون: | Elisa Selmin, Dalla Costa M, Corrado Betterle, Marco Boscaro, Giorgia Antonelli, Chiara Sabbadin, Filippo Ceccato, Mario Plebani, Mattia Barbot, Carla Scaroni |
| المصدر: | Endocrine Connections Endocrine Connections, Vol 7, Iss 9, Pp 965-974 (2018) |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Saliva, medicine.medical_specialty, Evening, Dual release, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Rhythm, Internal medicine, Internal Medicine, Adrenal insufficiency, medicine, Circadian rhythm, Salivary cortisol, Morning, Hydrocortisone, lcsh:RC648-665, business.industry, Research, Area under the curve, medicine.disease, glucocorticoid therapy, salivary cortisol, dual release hydrocortisone, dual-release hydrocortisone, 030220 oncology & carcinogenesis, salivary cortisol, adrenal insufficiency, glucocorticoid therapy, cortisol rhythm, dual release hydrocortisone, Cortisone, business, adrenal insufficiency, cortisol rhythm, hormones, hormone substitutes, and hormone antagonists, medicine.drug |
| الوصف: | Introduction and Aim The purpose of replacement therapy in adrenal insufficiency (AI) is mimicking endogenous cortisol levels as closely as possible: dual release hydrocortisone (DR-HC) has been introduced to replicate the circadian cortisol rhythm. Multiple daily saliva collections could be used to assess the cortisol rhythm during real life: our aim was to study the salivary cortisol profile in AI. Materials and Methods We prospectively evaluated, in an observational study, 18 adult outpatients with AI (11 primary and 7 secondary AI), switched from conventional treatment (conv-HC, 25 mg/day) to the same dose of DR-HC. We collected six samples of saliva in a day, measuring cortisol (F) and cortisone (E) with LC-MS/MS. Forty-three matched healthy subjects served as controls. Results F levels were similar in the morning (and higher than controls) in patients treated with conv-HC or DR-HC; otherwise F levels and exposure were lower in the afternoon and evening in patients with DR-HC, achieving a cortisol profile closer to healthy controls. Daily cortisol exposure, measured with area under the curve, was lower with DR-HC. Morning F and E presented sensitivity and specificity >90% to diagnose AI (respectively threshold of 3 and 9.45 nmol/L). Total cholesterol and HbA1c levels reduced with DR-HC. Conclusions Salivary cortisol daily curve could be used as a new tool to assess the cortisol profiles in patients treated with conv-HC and DR-HC. A lower daily cortisol exposure was achieved with DR-HC (despite the same HC dose), especially in the afternoon-evening. |
| تدمد: | 2049-3614 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1c101809853b8ee52e7d1197ba922ba8Test https://pubmed.ncbi.nlm.nih.gov/30300536Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1c101809853b8ee52e7d1197ba922ba8 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20493614 |
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