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Improved salivary cortisol rhythm with dual-release hydrocortisone
- Source :
-
Endocrine connections [Endocr Connect] 2018 Sep 01; Vol. 7 (9), pp. 965-974. Date of Electronic Publication: 2018 Sep 01. - Publication Year :
- 2018
-
Abstract
- 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.<br />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.<br />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.<br />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.<br /> (© 2018 The authors)
Details
- Language :
- English
- ISSN :
- 2049-3614
- Volume :
- 7
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Endocrine connections
- Publication Type :
- Academic Journal
- Accession number :
- 30300536
- Full Text :
- https://doi.org/10.1530/EC-18-0257