Exaggerated adrenarche and altered cortisol metabolism in Type 1 diabetic children

Steroids
Thomas RemerStefan A Wudy

Abstract

Reported literature data strongly suggest that steroid metabolism is dysregulated in Type 1 diabetes mellitus. The aim of this study was to non-invasively examine the cortisol metabolism in children with Type 1 diabetes mellitus (T1DM) in detail and to test the hypothesis that adrenarche is affected under conventional intensive insulin therapy. In 24-h urine samples of 109 patients aged 4-18 years with T1DM of more than 1 year, steroids were profiled using gas chromatography-mass spectrometry. Additionally, urinary free cortisol (UFF) and cortisone (UFE) were quantified by RIA after extraction and chromatographic purification. Data on urinary steroids from 400 healthy controls served as reference values. Enzyme activities were assessed by established steroid metabolite ratios, e.g. 5alpha-reductase and 11beta-hydroxysteroid dehydrogenase Type 2 (11beta-HSD2) by 5alpha-tetrahydrocortisol/tetrahydrocortisol and UFE/UFF, respectively. Urinary markers of adrenarche, especially dehydroepiandrosterone and its direct metabolites were elevated in patients, as were urinary 6beta-hydroxycortisol, UFE, and 11beta-HSD2 activity. However, overall cortisol secretion, as reflected by the sum of major urinary cortisol metabolites, was mostly n...Continue Reading

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Citations

Jul 3, 2010·Psychosomatic Medicine·Thomas Remer, Lijie Shi
Jul 31, 2008·Clinical Endocrinology·Sarah KonopelskaMarcus Quinkler
Oct 7, 2010·Journal of Diabetes·Tanya HyattKenneth McCormick
Oct 15, 2011·Pediatric Diabetes·Ethel CodnerPaulina M Merino
Sep 10, 2014·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Lijie ShiThomas Remer
Oct 1, 2011·Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology·Akiko NishimuraKenji Ohyama
Feb 26, 2013·The Journal of Steroid Biochemistry and Molecular Biology·Andrzej SlominskiRobert C Tuckey
Feb 21, 2019·Diabetic Medicine : a Journal of the British Diabetic Association·Y YiT Costacou
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Nov 13, 2008·The Journal of Clinical Endocrinology and Metabolism·Thomas RemerStefan A Wudy
Jan 7, 2014·Clinical Chemistry and Laboratory Medicine : CCLM·Giorgia AntonelliMario Plebani
Oct 2, 2009·The American Journal of Clinical Nutrition·Lijie ShiThomas Remer

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