Simunkova K, Duskova M, Kosak M, Krsek M, Hana V, Hill M, Jandikova H, Pospisilova H, Sramkova M, Bifulco E, Starka L
Third department of Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic.
Physiol Res. 2015;64(Suppl 2):S237-46. doi: 10.33549/physiolres.933133.
Determination of response of cortisol and its metabolites to different stimuli may be important for adrenal gland disorders. To date, only one metabolite, cortisone, has been followed in stimulation tests of the adrenal gland. We aimed to describe a response of cortisol metabolites to the standard short Synacthen test (HDST), insulin tolerance test (ITT), low dose Synacthen test (LDST) and medium dose Synacthen test (MDST). Sixty healthy subjects were investigated: 30 men and 30 women. Plasma for measurements of cortisol and its metabolites was obtained before and 30th and 60th min after Synacthen and insulin administration. The cut-off 500 nmol/l of cortisol was reached after stimulation in all of tests, the maximal stimulation level was reached in 60th min in all of the tests except for LDST. The response of cortisol and its metabolites at 30th and 60th min strongly correlated in all of the tests except for LDST. Cortisol and its metabolites increased after stimulation; in contrast, cortisone and its metabolites decreased. We showed that the response of the cortisol metabolites during the Synacthen tests and ITT well correlated, and the MDST showed similar response compared to HDST. The decrease in cortisone metabolites may correspond to the regeneration of cortisol from cortisone in response to stimulation test.
测定皮质醇及其代谢产物对不同刺激的反应可能对肾上腺疾病很重要。迄今为止，在肾上腺刺激试验中仅追踪了一种代谢产物——可的松。我们旨在描述皮质醇代谢产物对标准短程促肾上腺皮质激素试验（HDST）、胰岛素耐量试验（ITT）、低剂量促肾上腺皮质激素试验（LDST）和中剂量促肾上腺皮质激素试验（MDST）的反应。对60名健康受试者进行了研究：30名男性和30名女性。在注射促肾上腺皮质激素和胰岛素之前以及之后第30分钟和第60分钟采集用于测量皮质醇及其代谢产物的血浆。在所有试验中，刺激后皮质醇均达到500 nmol/l的临界值，除LDST外，所有试验均在第60分钟达到最大刺激水平。除LDST外，在所有试验中，第30分钟和第60分钟时皮质醇及其代谢产物的反应密切相关。刺激后皮质醇及其代谢产物增加；相反，可的松及其代谢产物减少。我们发现，促肾上腺皮质激素试验和ITT期间皮质醇代谢产物的反应密切相关，与HDST相比，MDST显示出相似的反应。可的松代谢产物的减少可能对应于可的松在刺激试验中转化为皮质醇的过程。
