PERFORMANCE OF FREE VERSUS TOTAL CORTISOL FOLLOWING COSYNTROPIN STIMULATION TESTING IN AN OUTPATIENT SETTING.

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
Irina BancosRavinder Singh

Abstract

Free cortisol (FC) is potentially superior to total cortisol (TC) measurements in selected clinical settings; however, the advantages of uniform use of FC in outpatient settings are unclear. The objectives of this study were to describe the dynamic response of FC during cosyntropin stimulation testing (CST) compared to TC and to determine the rates of discordance. This is a cross-sectional study of 295 stable patients who underwent CST in an outpatient Endocrine Testing Center. The main outcome measures were TC and FC measurements during CST. The mean age of the 295 subjects was 49.1 (16.9) years. Of 218 females, 43 were taking estrogen therapy (ET) at the time of testing. Adrenal insufficiency (AI) was diagnosed in 41/295 (14%) patients. The FC concentrations were associated with TC concentrations at baseline (R(2) = 0.77, P<.001), 30 minutes (R(2) = 0.87, P<.001), and 60 minutes (R(2) = 0.90, P<.001). The FC cutoffs for AI were 873 and 1,170 ng/dL at 30 and 60 minutes, respectively. The FC had a more pronounced fold change from baseline to peak than TC (median 3.2 vs. 1.7, P<.001). Both TC and FC at baseline were higher in females on ET compared to those who were not and to males; however, peak TC and FC values were similar. ...Continue Reading

References

Jan 1, 1991·The Journal of Steroid Biochemistry and Molecular Biology·G L HammondD A Underhill
Apr 1, 1972·Journal of Steroid Biochemistry·W Rosner
Feb 1, 1997·The Journal of Steroid Biochemistry and Molecular Biology·E G LentjesA J Moolenaar
Feb 18, 1999·The Journal of Clinical Endocrinology and Metabolism·E G Lentjes, F H Romijn
Apr 29, 1999·Clinical Chemistry and Laboratory Medicine : CCLM·H A BonteI Vermes
Dec 21, 2002·Clinical Biochemistry·Michael VogeserReinhart Zachoval
May 3, 2003·The Journal of Clinical Endocrinology and Metabolism·C W le RouxJ Alaghband-Zadeh
Aug 6, 2003·Annals of Internal Medicine·Richard I DorinLawrence M Crapo
Apr 16, 2004·The New England Journal of Medicine·Amir H HamrahianBaha M Arafah
Jun 10, 2004·American Journal of Physiology. Endocrinology and Metabolism·Daniel M KeenanJohannes D Veldhuis
May 21, 2005·Clinica Chimica Acta; International Journal of Clinical Chemistry·John G LewisDavid J Torpy
Nov 3, 2005·The Journal of Clinical Endocrinology and Metabolism·J T HoD J Torpy
May 16, 2006·Hormone and Metabolic Research = Hormon- Und Stoffwechselforschung = Hormones Et Métabolisme·J G LewisP A Elder
Aug 10, 2006·The Journal of Clinical Endocrinology and Metabolism·Daesman SuriRoy E Weiss
Nov 4, 2008·Clinical Biochemistry·Richard I DorinClifford R Qualls
Apr 14, 2010·Journal of Hepatology·Arnaud GalboisDominique Thabut
Aug 6, 2010·The Journal of Clinical Endocrinology and Metabolism·I PerogamvrosP J Trainer
Mar 4, 2011·The Journal of Clinical Endocrinology and Metabolism·Caroline JungWarrick J Inder
Jun 21, 2013·The Journal of Clinical Endocrinology and Metabolism·Wee Lee ChanRandy J Read
Feb 28, 2014·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·Animesh N SharmaJohannes D Veldhuis
Aug 8, 2014·The Lancet. Diabetes & Endocrinology·Irina BancosWiebke Arlt

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Citations

Aug 20, 2016·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Yael SoferNaftali Stern
May 10, 2020·The Journal of Clinical Endocrinology and Metabolism·Ronald S SwerdloffTheodore M Danoff
Aug 9, 2020·The Journal of Clinical Endocrinology and Metabolism·Richard J Auchus
Apr 23, 2019·The Journal of Clinical Endocrinology and Metabolism·Laura E DichtelKaren K Miller
Oct 6, 2015·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Richard J Auchus
Mar 27, 2021·Reviews in Endocrine & Metabolic Disorders·Zuleyha KaracaFahrettin Kelestimur
Jul 14, 2021·BMJ : British Medical Journal·Alessandro Prete, Irina Bancos
Oct 15, 2021·The Journal of Clinical Endocrinology and Metabolism·Natalia GenereIrina Bancos

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