title: Response of cortisol metabolites in the insulin tolerance test and Synacthen tests.
abstract: 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.
authors.affiliation: Third department of Medicine, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic. ksimunkova@gmail.com.
authors.forename: K
authors.initials: K
authors.lastname: Simunkova
authors.forename: M
authors.initials: M
authors.lastname: Duskova
authors.forename: M
authors.initials: M
authors.lastname: Kosak
authors.forename: M
authors.initials: M
authors.lastname: Krsek
authors.forename: V
authors.initials: V
authors.lastname: Hana
authors.forename: M
authors.initials: M
authors.lastname: Hill
authors.forename: H
authors.initials: H
authors.lastname: Jandikova
authors.forename: H
authors.initials: H
authors.lastname: Pospisilova
authors.forename: M
authors.initials: M
authors.lastname: Sramkova
authors.forename: E
authors.initials: E
authors.lastname: Bifulco
authors.forename: L
authors.initials: L
authors.lastname: Starka
mesh_terms: D000328:Adult; D003348:Cortisone / Q000819:agonists / Q000097:blood*; D003366:Cosyntropin / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000819:agonists / Q000097:blood*; D007328:Insulin / Q000819:agonists / Q000097:blood*; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged
chemical_list: D007328:Insulin; D003366:Cosyntropin; C006418:adrenocorticotropin zinc; D003348:Cortisone; D006854:Hydrocortisone