dc.contributor.author | Sævik, Åse Bjorvatn | |
dc.contributor.author | Åkerman, Anna-Karin | |
dc.contributor.author | Methlie, Paal | |
dc.contributor.author | Quinkler, Marcus | |
dc.contributor.author | Jørgensen, Anders Palmstrøm | |
dc.contributor.author | Høybye, Charlotte | |
dc.contributor.author | Debowska, Aleksandra | |
dc.contributor.author | Nedrebø, Bjørn Gunnar | |
dc.contributor.author | Dahle, Anne Lise | |
dc.contributor.author | Carlsen, Siri | |
dc.contributor.author | Tomkowicz, Aneta | |
dc.contributor.author | Sollid, Stina Therese | |
dc.contributor.author | Nermoen, Ingrid | |
dc.contributor.author | Grønning, Kaja | |
dc.contributor.author | Dahlqvist, Per | |
dc.contributor.author | Grimnes, Guri | |
dc.contributor.author | Skov, Jakob | |
dc.contributor.author | Finnes, Trine Elisabeth | |
dc.contributor.author | Valland, Susanna Fonneland | |
dc.contributor.author | Wahlberg, Jeanette | |
dc.contributor.author | Holte, Synnøve Emblem | |
dc.contributor.author | Simunkova, Katerina | |
dc.contributor.author | Kämpe, Olle | |
dc.contributor.author | Husebye, Eystein Sverre | |
dc.contributor.author | Bensing, Sophie | |
dc.contributor.author | Øksnes, Marianne | |
dc.date.accessioned | 2023-04-12T09:03:32Z | |
dc.date.available | 2023-04-12T09:03:32Z | |
dc.date.created | 2020-05-18T09:46:11Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | J Clin Endocrinol Metab. 2020 Jul 1;105(7):2430-2441. | en_US |
dc.identifier.issn | 0021-972X | |
dc.identifier.uri | https://hdl.handle.net/11250/3062561 | |
dc.description.abstract | Design: Two-staged, cross-sectional clinical study in 17 centers (Norway, Sweden, and Germany). Residual glucocorticoid (GC) production was defined as quantifiable serum cortisol and 11-deoxycortisol and residual mineralocorticoid (MC) production as quantifiable serum aldosterone and corticosterone after > 18 hours of medication fasting. Corticosteroids were analyzed by liquid chromatography–tandem mass spectrometry. Clinical variables included frequency of adrenal crises and quality of life. Peak cortisol response was evaluated by a standard 250 µg cosyntropin test. Results: Fifty-eight (30.2%) of 192 patients had residual GC production, more common in men (n = 33; P < 0.002) and in shorter disease duration (median 6 [0-44] vs 13 [0-53] years; P < 0.001). Residual MC production was found in 26 (13.5%) patients and associated with shorter disease duration (median 5.5 [0.5-26.0] vs 13 [0-53] years; P < 0.004), lower fludrocortisone replacement dosage (median 0.075 [0.050-0.120] vs 0.100 [0.028-0.300] mg; P < 0.005), and higher plasma renin concentration (median 179 [22-915] vs 47.5 [0.6-658.0] mU/L; P < 0.001). There was no significant association between residual production and frequency of adrenal crises or quality of life. None had a normal cosyntropin response, but peak cortisol strongly correlated with unstimulated cortisol (r = 0.989; P < 0.001) and plasma adrenocorticotropic hormone (ACTH; r = –0.487; P < 0.001). Conclusion: In established AAD, one-third of the patients still produce GCs even decades after diagnosis. Residual production is more common in men and in patients with shorter disease duration but is not associated with adrenal crises or quality of life. (J Clin Endocrinol Metab 105: 1–12, 2020) Key words: Adrenal failure; adrenal steroids; Autoimmune Addison disease; cortisol; primary adrenal insufficiency; residual function | en_US |
dc.language.iso | eng | en_US |
dc.relation.uri | https://watermark.silverchair.com/dgaa256.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAsEwggK9BgkqhkiG9w0BBwagggKuMIICqgIBADCCAqMGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMYq9rqnZNImGmnXN1 | |
dc.rights | Navngivelse 4.0 Internasjonal | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/deed.no | * |
dc.subject | Adrenal failure; | en_US |
dc.subject | Autoimmune Addison disease; | en_US |
dc.subject | adrenal steroids; | en_US |
dc.subject | cortisol; | en_US |
dc.subject | primary adrenal insufficiency; | en_US |
dc.subject | residual function; | en_US |
dc.title | Residual Corticosteroid Production in Autoimmune Addison Disease | en_US |
dc.type | Peer reviewed | en_US |
dc.type | Journal article | en_US |
dc.description.version | publishedVersion | en_US |
dc.rights.holder | © Endocrine Society 2020. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. | en_US |
dc.source.volume | 105 | en_US |
dc.source.journal | Journal of Clinical Endocrinology and Metabolism | en_US |
dc.source.issue | 7 | en_US |
dc.identifier.doi | 10.1210/clinem/dgaa256 | |
dc.identifier.cristin | 1811428 | |
dc.relation.project | Norges forskningsråd: 288022 | en_US |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |