Free Cortisol and Free 21-Deoxycortisol in the Clinical Evaluation of Congenital Adrenal Hyperplasia
Authors' conclusion
Free cortisol concentrations in patients with classic CAH were similar to those in controls and patients with NCCAH, indicating comparable cortisol availability. Additionally, patients with 21OHD produce high concentrations of 21DF, possibly explaining the low occurrence of symptoms in some patients with classic 21OHD. Free cortisol and 21DF levels should be considered in evaluating adrenal insufficiency in patients with CAH.
Study context
- Population
- Patients with untreated classic congenital adrenal hyperplasia (CAH), nonclassic CAH (NCCAH), other forms of adrenal insufficiency (AI), and controls
- Participants
- 29 / 5 / 3 / 11
- Comparison
- Untreated classic CAH vs NCCAH, AI and controls
- Untreated classic CAHn = 29
- NCCAHn = 5
- AIn = 3
- Controlsn = 11reference
- Outcome
- Total and free serum cortisol and 21-deoxycortisol (21DF) concentrations
- Follow-up
- Before and 60 minutes after Synacthen
Methodological detailsLC-MS/MS, Synacthen stimulation
- LC-MS/MS
- Synacthen stimulation
Performance
As reported in the abstract
Untreated classic CAH
109
median · nmol/L
NCCAH
249
nmol/L
Controls
202
nmol/L
Untreated classic CAH vs NCCAH: P = 0.010 · Untreated classic CAH vs Controls: P = 0.016
Further findings
Basal free 21DF
- High in patients with 21OHD (median)
- 5.32 nmol/L
- Undetectable in AI and controls
- <0.19 nmol/L
Free 21DF and free cortisol after Synacthen · 60 minutes after Synacthen
- Free 21DF increased in 21OHD, while free cortisol did not change
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →