Hormonal circadian rhythms in patients with congenital adrenal hyperplasia: identifying optimal monitoring times and novel disease biomarkers

European Journal of Endocrinology
Miguel DebonoD P Merke

Abstract

The treatment goal in congenital adrenal hyperplasia (CAH) is to replace glucocorticoids while avoiding androgen excess and iatrogenic Cushing's syndrome. However, there is no consensus on how to monitor disease control. Our main objectives were to evaluate hormonal circadian rhythms and use these profiles to identify optimal monitoring times and novel disease biomarkers in CAH adults on intermediate- and long-acting glucocorticoids. This was an observational, cross-sectional study at the National Institutes of Health Clinical Center in 16 patients with classic CAH. Twenty-four-hour serum sampling for ACTH, 17-hydroxyprogesterone (17OHP), androstenedione (A4), androsterone, DHEA, testosterone, progesterone and 24-h urinary pdiol and 5β-pdiol was carried out. Bayesian spectral analysis and cosinor analysis were performed to detect circadian rhythmicity. The number of hours to minimal (TminAC) and maximal (TmaxAC) adrenocortical hormone levels after dose administration was calculated. A significant rhythm was confirmed for ACTH (r(2), 0.95; P<0.001), 17OHP (r(2), 0.70; P=0.003), androstenedione (r(2), 0.47; P=0.043), androsterone (r(2), 0.80; P<0.001), testosterone (r(2), 0.47; P=0.042) and progesterone (r(2), 0.64; P=0.006). The...Continue Reading

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Apr 1, 2016·Current Opinion in Endocrinology, Diabetes, and Obesity·Adina F Turcu, Richard J Auchus
Oct 3, 2018·The Journal of Clinical Endocrinology and Metabolism·Phyllis W SpeiserPerrin C White
Jul 31, 2019·The Journal of Clinical Endocrinology and Metabolism·Irina BacilaNils Krone
Feb 3, 2021·The Journal of Clinical Endocrinology and Metabolism·Deborah P MerkeRichard J Ross
Jun 25, 2021·The Journal of Clinical Endocrinology and Metabolism·Hanna Franziska NowotnyNicole Reisch
Jun 20, 2021·The Journal of Clinical Endocrinology and Metabolism·Kyriakie SarafoglouRichard J Auchus
May 8, 2021·Endocrine Reviews·Hedi L Claahsen-van der GrintenPerrin C White
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Oct 26, 2021·The Journal of Clinical Endocrinology and Metabolism·Ariane DelaiLivia M Mermejo

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