دورية أكاديمية
Ketoconazole- and Metyrapone-Induced Reductions on Urinary Steroid Metabolites Alter the Urinary Free Cortisol Immunoassay Reliability in Cushing Syndrome
| العنوان: | Ketoconazole- and Metyrapone-Induced Reductions on Urinary Steroid Metabolites Alter the Urinary Free Cortisol Immunoassay Reliability in Cushing Syndrome |
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| المؤلفون: | Vega Beyhart, Arturo, Laguna Moreno, Javier, Díaz Catalán, Daniela, Boswell, Laura, Mora Porta, Mireia, Halperin, Irene, Casals, Gregori, Hanzu, Felicia Alexandra |
| المصدر: | Articles publicats en revistes (Medicina) |
| بيانات النشر: | Frontiers Media |
| سنة النشر: | 2022 |
| المجموعة: | Dipòsit Digital de la Universitat de Barcelona |
| مصطلحات موضوعية: | Síndrome de Cushing, Immunoassaig, Ketoconazole, Esteroides, Cushing's syndrome, Immunoassay, Steroids |
| الوصف: | Introduction: Twenty-four-hour urinary free cortisol (24h-UFC) is the most used test for follow-up decision-making in patients with Cushing syndrome (CS) under medical treatment. However, 24h-UFC determinations by immunoassays (IA) are commonly overestimated because of steroid metabolites' cross-reaction. It is still uncertain how ketoconazole (KTZ)- and metyrapone (MTP)-induced changes on the urinary steroid metabolites can alter the 24h-UFC*IA determinations' reliability. Methods: 24h-UFC was analyzed by IA and gas chromatography-mass spectrometry (GC-MS) in 193 samples (81 before treatment, 73 during KTZ, and 39 during MTP) from 34 CS patients. In addition, urinary steroidome was analyzed by GC-MS on each patient before and during treatment. Results: Before treatment, 24h-UFC*IA determinations were overestimated by a factor of 1.75 (95% CI 1.60-1.94) compared to those by GC-MS. However, during KTZ treatment, 24h-UFC*IA results were similar (0.98:1) to those by GC-MS (95% CI, 0.83-1.20). In patients taking MTP, IA bias only decreased 0.55, resulting in persistence of an overestimation factor of 1.33:1 (95% CI, 1.09-1.76). High method agreement between GC-MS and IA before treatment (R2 = 0.954) declined in patients under KTZ (R2 = 0.632) but not in MTP (R2 = 0.917). Upper limit normal (ULN) reductions in patients taking KTZ were 27% larger when using 24h-UFC*IA compared to 24h-UFC*GC-MS, which resulted in higher false efficacy and misleading biochemical classification of 15% of patients. Urinary excretion changes of 22 urinary steroid metabolites explained 86% of the 24h-UFC*IA interference. Larger urinary excretion reductions of 6β-hydroxy-cortisol, 20α-dihydrocortisol, and 18-hydroxy-cortisol in patients with KTZ elucidated the higher 24h-UFC*IA bias decrement compared to MTP-treated patients. Conclusion: KTZ and MTP alter the urinary excretion of IA cross-reactive steroid metabolites, thus decreasing the cross-reactive interference of 24h-UFC*IA determinations present before treatment. Consequently, this ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | 12 p.; application/pdf |
| اللغة: | English |
| تدمد: | 1664-2392 |
| العلاقة: | Reproducció del document publicat a: https://doi.org/10.3389/fendo.2022.833644Test; Frontiers In Endocrinology, 2022, vol. 13, p. 833644; https://doi.org/10.3389/fendo.2022.833644Test; http://hdl.handle.net/2445/210080Test; 743043; 9300542 |
| الإتاحة: | https://doi.org/10.3389/fendo.2022.833644Test http://hdl.handle.net/2445/210080Test |
| حقوق: | cc-by (c) Vega-Beyhart, A. et al., 2022 ; http://creativecommons.org/licenses/by/4.0Test/ ; info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.8D7E05D1 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 16642392 |
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