| HDL-cholesterol level and cortisol response to synacthen in critically ill patients. | |
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MedLine Citation:
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PMID: 14566456 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To explore the relationship between cholesterol levels and the adrenal cortisol response to synacthen in critically ill patients. DESIGN: Prospective observational study. PATIENTS: Critically ill patients with multiple organ dysfunction syndrome (MODS) with possible adrenal dysfunction defined as unexplained hypotension, ongoing inotropic support, unexplained fever, unexplained hyponatraemia or a combination of these symptoms. MEASUREMENTS: HDL-cholesterol levels (HDL), total cholesterol levels (TC), and triglycerides (TG) before administration of synacthen. LDL-cholesterol was calculated using the Friedewald formula. Basal cortisol and response to 250 microg synacthen intravenously was measured. A cortisol rise of 0.25 micromol/l in a 30-min or 60-min blood sample after synacthen infusion was defined as a proper adrenal response. RESULTS: Patients with a proper response to synacthen showed higher HDL-cholesterol levels than patients without that response ( P=0.02). Severity of disease as measured by APACHE II or SOFA was not a confounder. LDL-cholesterol levels were extremely low in both responders and non-responders and were not associated with the absolute rise in cortisol. In linear and logistic regression analysis HDL-cholesterol was the sole predictor of cortisol response. CONCLUSIONS: Adrenal cortisol response to a "classic" 250-microg synacthen test relates in critically ill patients to HDL-cholesterol levels. LDL and TC levels did not show such a relation. These findings are in concordance with known biochemical pathways of cortisol production. |
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Authors:
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Peter H J van der Voort; Rik T Gerritsen; Andries J Bakker; E Christiaan Boerma; Michael A Kuiper; Loek de Heide |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2003-10-18 |
Journal Detail:
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Title: Intensive care medicine Volume: 29 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2003 Dec |
Date Detail:
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Created Date: 2003-12-03 Completed Date: 2004-04-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2199-203 Citation Subset: IM |
Affiliation:
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Department of Intensive Care, Medical Centre Leeuwarden, PO Box 888, 8901 BR, Leeuwarden, The Netherlands. phjvdvoort@wxs.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Cholesterol, HDL / blood* Cosyntropin / therapeutic use* Critical Care Humans Hydrocortisone / blood* Logistic Models Middle Aged Multiple Organ Failure / blood, drug therapy* Prospective Studies Severity of Illness Index Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Cholesterol, HDL; 16960-16-0/Cosyntropin; 50-23-7/Hydrocortisone; 53468-06-7/adrenocorticotropin zinc |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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