Urinary cortisol metabolites and ratios in controls and patients receiving dual-release hydrocortisone and 3-times-daily hydrocortisone
| . | Controls . | Patients . | . | . | Adjusted P . | . | . |
|---|---|---|---|---|---|---|---|
| . | . | TID-HC . | DR-HC . | Difference TID-HC–DR-HC . | Controls vs TID-HCa . | Controls vs DR-HCa . | TID-HC vs DR-HCb . |
| Steroids, μg/24 h | |||||||
| UFF | 48 (36 to 66) | 149 (93 to 239) | 84 (56 to 127) | 59 (26 to 125) | < .001 | < .001 | < .001 |
| THF | 1259 (838 to 1615) | 2558 (1758 to 3178) | 1617 (1229 to 2128) | 913 (425 to 1360) | < .001 | .02 | < .001 |
| 5α-THF | 1000 (553 to 1481) | 1202 (755 to 1891) | 859 (473 to 1334) | 280 (99 to 466) | .3 | .001 | < .001 |
| α-Cortol | 242 (177 to 317) | 271 (228 to 366) | 181 (139 to 256) | 101 (38 to 158) | .77 | < .001 | < .001 |
| β-Cortol | 408 (259 to 574) | 352 (229 to 526) | 285 (200 to 650) | 19 (–75 to 110) | .85 | .92 | .74 |
| UFE | 76 (60 to 100) | 225 (156 to 280) | 144 (97 to 195) | 66 (25 to 124) | < .001 | < .001 | < .001 |
| THE | 2364 (1735 to 3231) | 2445 (1995 to 3142) | 1817 (1398 to 2291) | 656 (151 to 1214) | .07 | < .001 | < .001 |
| α-Cortolone | 966 (714 to 1306) | 755 (573 to 905) | 534 (399 to 713) | 193 (75 to 336) | < .001 | < .001 | < .001 |
| β-Cortolone | 532 (372 to 698) | 420 (293 to 539) | 327 (222 to 460) | 92 (–5 to –168) | < .001 | < .001 | < .001 |
| 6β-OH-F | 106 (81 to 154) | 213 (121 to 378) | 99 (68 to 185) | 86 (49 to 175) | < .001 | .8 | < .001 |
| TCM | 6850 (4930 to 9159) | 8825 (6838 to 10 888) | 6380 (4421 to 7874) | 2337 (1239 to 4112) | .52 | .004 | < .001 |
| Steroids ratio | |||||||
| UFE/UFF | 1.56 (1.32 to 1.84) | 1.41 (1.14 to 1.59) | 1.64 (1.37 to 1.97) | –0.24 (–0.47 to –0.07) | < .001 | .85 | < .001 |
| (THF + 5α-THF)/THE | 0.89 (0.74 to 1.09) | 1.38 (1.2 to 1.75) | 1.39 (1.05 to 1.62) | 0.09 (–0.04 to 0.37) | < .001 | < .001 | .003 |
| THF/5α-THF | 1.26 (0.93 to 1.71) | 2.27 (1.28 to 3.34) | 1.98 (1.30 to 3.549) | 0.02 (–0.21 to 0.40) | < .001 | < .001 | .32 |
| Cortols/THF | 0.50 (0.42 to 0.67) | 0.28 (0.22 to 0.34) | 0.33 (0.24 to 0.44) | –0.06 (–0.17 to –0.01) | < .001 | < .001 | < .001 |
| Cortolones/THE | 0.62 (0.53 to 0.72) | 0.45 (0.4 to 0.56) | 0.47 (0.4 to 0.58) | –0.01 (–0.04 to 0.02) | < .001 | < .001 | .12 |
| α-Cortol/THF | 0.20 (0.17 to 0.25) | 0.12 (0.1 to 0.14) | 0.11 (0.1 to 0.14) | –0.00 (–0.01 to 0.01) | < .001 | < .001 | .74 |
| α-Cortolone/THE | 0.41 (0.33 to 0.48) | 0.29 (0.25 to 0.34) | 0.28 (0.24 to 0.36) | –0.01 (–0.01 to 0.03) | < .001 | < .001 | .3 |
| β-Cortol/THF | 0.29 (0.23 to 0.42) | 0.14 (0.11 to 0.21) | 0.19 (0.14 to 0.35) | –0.05 (–0.16 to –0.01) | < .001 | .067 | < .001 |
| β-Cortolone/THE | 0.21 (0.18 to 0.25) | 0.16 (0.14 to 0.2) | 0.17 (0.15 to 0.23) | –0.01 (–0.03 to 0.00) | .41 | .7 | < .001 |
| . | Controls . | Patients . | . | . | Adjusted P . | . | . |
|---|---|---|---|---|---|---|---|
| . | . | TID-HC . | DR-HC . | Difference TID-HC–DR-HC . | Controls vs TID-HCa . | Controls vs DR-HCa . | TID-HC vs DR-HCb . |
| Steroids, μg/24 h | |||||||
| UFF | 48 (36 to 66) | 149 (93 to 239) | 84 (56 to 127) | 59 (26 to 125) | < .001 | < .001 | < .001 |
| THF | 1259 (838 to 1615) | 2558 (1758 to 3178) | 1617 (1229 to 2128) | 913 (425 to 1360) | < .001 | .02 | < .001 |
| 5α-THF | 1000 (553 to 1481) | 1202 (755 to 1891) | 859 (473 to 1334) | 280 (99 to 466) | .3 | .001 | < .001 |
| α-Cortol | 242 (177 to 317) | 271 (228 to 366) | 181 (139 to 256) | 101 (38 to 158) | .77 | < .001 | < .001 |
| β-Cortol | 408 (259 to 574) | 352 (229 to 526) | 285 (200 to 650) | 19 (–75 to 110) | .85 | .92 | .74 |
| UFE | 76 (60 to 100) | 225 (156 to 280) | 144 (97 to 195) | 66 (25 to 124) | < .001 | < .001 | < .001 |
| THE | 2364 (1735 to 3231) | 2445 (1995 to 3142) | 1817 (1398 to 2291) | 656 (151 to 1214) | .07 | < .001 | < .001 |
| α-Cortolone | 966 (714 to 1306) | 755 (573 to 905) | 534 (399 to 713) | 193 (75 to 336) | < .001 | < .001 | < .001 |
| β-Cortolone | 532 (372 to 698) | 420 (293 to 539) | 327 (222 to 460) | 92 (–5 to –168) | < .001 | < .001 | < .001 |
| 6β-OH-F | 106 (81 to 154) | 213 (121 to 378) | 99 (68 to 185) | 86 (49 to 175) | < .001 | .8 | < .001 |
| TCM | 6850 (4930 to 9159) | 8825 (6838 to 10 888) | 6380 (4421 to 7874) | 2337 (1239 to 4112) | .52 | .004 | < .001 |
| Steroids ratio | |||||||
| UFE/UFF | 1.56 (1.32 to 1.84) | 1.41 (1.14 to 1.59) | 1.64 (1.37 to 1.97) | –0.24 (–0.47 to –0.07) | < .001 | .85 | < .001 |
| (THF + 5α-THF)/THE | 0.89 (0.74 to 1.09) | 1.38 (1.2 to 1.75) | 1.39 (1.05 to 1.62) | 0.09 (–0.04 to 0.37) | < .001 | < .001 | .003 |
| THF/5α-THF | 1.26 (0.93 to 1.71) | 2.27 (1.28 to 3.34) | 1.98 (1.30 to 3.549) | 0.02 (–0.21 to 0.40) | < .001 | < .001 | .32 |
| Cortols/THF | 0.50 (0.42 to 0.67) | 0.28 (0.22 to 0.34) | 0.33 (0.24 to 0.44) | –0.06 (–0.17 to –0.01) | < .001 | < .001 | < .001 |
| Cortolones/THE | 0.62 (0.53 to 0.72) | 0.45 (0.4 to 0.56) | 0.47 (0.4 to 0.58) | –0.01 (–0.04 to 0.02) | < .001 | < .001 | .12 |
| α-Cortol/THF | 0.20 (0.17 to 0.25) | 0.12 (0.1 to 0.14) | 0.11 (0.1 to 0.14) | –0.00 (–0.01 to 0.01) | < .001 | < .001 | .74 |
| α-Cortolone/THE | 0.41 (0.33 to 0.48) | 0.29 (0.25 to 0.34) | 0.28 (0.24 to 0.36) | –0.01 (–0.01 to 0.03) | < .001 | < .001 | .3 |
| β-Cortol/THF | 0.29 (0.23 to 0.42) | 0.14 (0.11 to 0.21) | 0.19 (0.14 to 0.35) | –0.05 (–0.16 to –0.01) | < .001 | .067 | < .001 |
| β-Cortolone/THE | 0.21 (0.18 to 0.25) | 0.16 (0.14 to 0.2) | 0.17 (0.15 to 0.23) | –0.01 (–0.03 to 0.00) | .41 | .7 | < .001 |
Results are presented as median (interquartile range).
Abbreviations: 5α-THF, 5α-tetrahydrocortisol; 6β-OH-F, 6β-hydroxy-cortisol; DR-HC, dual-release hydrocortisone; TCM, total cortisol metabolites; THE, tetrahydrocortisone; THF, tetrahydrocortisol; TID-HC, 3-times-daily hydrocortisone; UFE, urinary free cortisone; UFF, urinary free cortisol.
a P value adjusted for age, sex, and weight using logistic regression.
bPeriod-adjusted P value.
Urinary cortisol metabolites and ratios in controls and patients receiving dual-release hydrocortisone and 3-times-daily hydrocortisone
| . | Controls . | Patients . | . | . | Adjusted P . | . | . |
|---|---|---|---|---|---|---|---|
| . | . | TID-HC . | DR-HC . | Difference TID-HC–DR-HC . | Controls vs TID-HCa . | Controls vs DR-HCa . | TID-HC vs DR-HCb . |
| Steroids, μg/24 h | |||||||
| UFF | 48 (36 to 66) | 149 (93 to 239) | 84 (56 to 127) | 59 (26 to 125) | < .001 | < .001 | < .001 |
| THF | 1259 (838 to 1615) | 2558 (1758 to 3178) | 1617 (1229 to 2128) | 913 (425 to 1360) | < .001 | .02 | < .001 |
| 5α-THF | 1000 (553 to 1481) | 1202 (755 to 1891) | 859 (473 to 1334) | 280 (99 to 466) | .3 | .001 | < .001 |
| α-Cortol | 242 (177 to 317) | 271 (228 to 366) | 181 (139 to 256) | 101 (38 to 158) | .77 | < .001 | < .001 |
| β-Cortol | 408 (259 to 574) | 352 (229 to 526) | 285 (200 to 650) | 19 (–75 to 110) | .85 | .92 | .74 |
| UFE | 76 (60 to 100) | 225 (156 to 280) | 144 (97 to 195) | 66 (25 to 124) | < .001 | < .001 | < .001 |
| THE | 2364 (1735 to 3231) | 2445 (1995 to 3142) | 1817 (1398 to 2291) | 656 (151 to 1214) | .07 | < .001 | < .001 |
| α-Cortolone | 966 (714 to 1306) | 755 (573 to 905) | 534 (399 to 713) | 193 (75 to 336) | < .001 | < .001 | < .001 |
| β-Cortolone | 532 (372 to 698) | 420 (293 to 539) | 327 (222 to 460) | 92 (–5 to –168) | < .001 | < .001 | < .001 |
| 6β-OH-F | 106 (81 to 154) | 213 (121 to 378) | 99 (68 to 185) | 86 (49 to 175) | < .001 | .8 | < .001 |
| TCM | 6850 (4930 to 9159) | 8825 (6838 to 10 888) | 6380 (4421 to 7874) | 2337 (1239 to 4112) | .52 | .004 | < .001 |
| Steroids ratio | |||||||
| UFE/UFF | 1.56 (1.32 to 1.84) | 1.41 (1.14 to 1.59) | 1.64 (1.37 to 1.97) | –0.24 (–0.47 to –0.07) | < .001 | .85 | < .001 |
| (THF + 5α-THF)/THE | 0.89 (0.74 to 1.09) | 1.38 (1.2 to 1.75) | 1.39 (1.05 to 1.62) | 0.09 (–0.04 to 0.37) | < .001 | < .001 | .003 |
| THF/5α-THF | 1.26 (0.93 to 1.71) | 2.27 (1.28 to 3.34) | 1.98 (1.30 to 3.549) | 0.02 (–0.21 to 0.40) | < .001 | < .001 | .32 |
| Cortols/THF | 0.50 (0.42 to 0.67) | 0.28 (0.22 to 0.34) | 0.33 (0.24 to 0.44) | –0.06 (–0.17 to –0.01) | < .001 | < .001 | < .001 |
| Cortolones/THE | 0.62 (0.53 to 0.72) | 0.45 (0.4 to 0.56) | 0.47 (0.4 to 0.58) | –0.01 (–0.04 to 0.02) | < .001 | < .001 | .12 |
| α-Cortol/THF | 0.20 (0.17 to 0.25) | 0.12 (0.1 to 0.14) | 0.11 (0.1 to 0.14) | –0.00 (–0.01 to 0.01) | < .001 | < .001 | .74 |
| α-Cortolone/THE | 0.41 (0.33 to 0.48) | 0.29 (0.25 to 0.34) | 0.28 (0.24 to 0.36) | –0.01 (–0.01 to 0.03) | < .001 | < .001 | .3 |
| β-Cortol/THF | 0.29 (0.23 to 0.42) | 0.14 (0.11 to 0.21) | 0.19 (0.14 to 0.35) | –0.05 (–0.16 to –0.01) | < .001 | .067 | < .001 |
| β-Cortolone/THE | 0.21 (0.18 to 0.25) | 0.16 (0.14 to 0.2) | 0.17 (0.15 to 0.23) | –0.01 (–0.03 to 0.00) | .41 | .7 | < .001 |
| . | Controls . | Patients . | . | . | Adjusted P . | . | . |
|---|---|---|---|---|---|---|---|
| . | . | TID-HC . | DR-HC . | Difference TID-HC–DR-HC . | Controls vs TID-HCa . | Controls vs DR-HCa . | TID-HC vs DR-HCb . |
| Steroids, μg/24 h | |||||||
| UFF | 48 (36 to 66) | 149 (93 to 239) | 84 (56 to 127) | 59 (26 to 125) | < .001 | < .001 | < .001 |
| THF | 1259 (838 to 1615) | 2558 (1758 to 3178) | 1617 (1229 to 2128) | 913 (425 to 1360) | < .001 | .02 | < .001 |
| 5α-THF | 1000 (553 to 1481) | 1202 (755 to 1891) | 859 (473 to 1334) | 280 (99 to 466) | .3 | .001 | < .001 |
| α-Cortol | 242 (177 to 317) | 271 (228 to 366) | 181 (139 to 256) | 101 (38 to 158) | .77 | < .001 | < .001 |
| β-Cortol | 408 (259 to 574) | 352 (229 to 526) | 285 (200 to 650) | 19 (–75 to 110) | .85 | .92 | .74 |
| UFE | 76 (60 to 100) | 225 (156 to 280) | 144 (97 to 195) | 66 (25 to 124) | < .001 | < .001 | < .001 |
| THE | 2364 (1735 to 3231) | 2445 (1995 to 3142) | 1817 (1398 to 2291) | 656 (151 to 1214) | .07 | < .001 | < .001 |
| α-Cortolone | 966 (714 to 1306) | 755 (573 to 905) | 534 (399 to 713) | 193 (75 to 336) | < .001 | < .001 | < .001 |
| β-Cortolone | 532 (372 to 698) | 420 (293 to 539) | 327 (222 to 460) | 92 (–5 to –168) | < .001 | < .001 | < .001 |
| 6β-OH-F | 106 (81 to 154) | 213 (121 to 378) | 99 (68 to 185) | 86 (49 to 175) | < .001 | .8 | < .001 |
| TCM | 6850 (4930 to 9159) | 8825 (6838 to 10 888) | 6380 (4421 to 7874) | 2337 (1239 to 4112) | .52 | .004 | < .001 |
| Steroids ratio | |||||||
| UFE/UFF | 1.56 (1.32 to 1.84) | 1.41 (1.14 to 1.59) | 1.64 (1.37 to 1.97) | –0.24 (–0.47 to –0.07) | < .001 | .85 | < .001 |
| (THF + 5α-THF)/THE | 0.89 (0.74 to 1.09) | 1.38 (1.2 to 1.75) | 1.39 (1.05 to 1.62) | 0.09 (–0.04 to 0.37) | < .001 | < .001 | .003 |
| THF/5α-THF | 1.26 (0.93 to 1.71) | 2.27 (1.28 to 3.34) | 1.98 (1.30 to 3.549) | 0.02 (–0.21 to 0.40) | < .001 | < .001 | .32 |
| Cortols/THF | 0.50 (0.42 to 0.67) | 0.28 (0.22 to 0.34) | 0.33 (0.24 to 0.44) | –0.06 (–0.17 to –0.01) | < .001 | < .001 | < .001 |
| Cortolones/THE | 0.62 (0.53 to 0.72) | 0.45 (0.4 to 0.56) | 0.47 (0.4 to 0.58) | –0.01 (–0.04 to 0.02) | < .001 | < .001 | .12 |
| α-Cortol/THF | 0.20 (0.17 to 0.25) | 0.12 (0.1 to 0.14) | 0.11 (0.1 to 0.14) | –0.00 (–0.01 to 0.01) | < .001 | < .001 | .74 |
| α-Cortolone/THE | 0.41 (0.33 to 0.48) | 0.29 (0.25 to 0.34) | 0.28 (0.24 to 0.36) | –0.01 (–0.01 to 0.03) | < .001 | < .001 | .3 |
| β-Cortol/THF | 0.29 (0.23 to 0.42) | 0.14 (0.11 to 0.21) | 0.19 (0.14 to 0.35) | –0.05 (–0.16 to –0.01) | < .001 | .067 | < .001 |
| β-Cortolone/THE | 0.21 (0.18 to 0.25) | 0.16 (0.14 to 0.2) | 0.17 (0.15 to 0.23) | –0.01 (–0.03 to 0.00) | .41 | .7 | < .001 |
Results are presented as median (interquartile range).
Abbreviations: 5α-THF, 5α-tetrahydrocortisol; 6β-OH-F, 6β-hydroxy-cortisol; DR-HC, dual-release hydrocortisone; TCM, total cortisol metabolites; THE, tetrahydrocortisone; THF, tetrahydrocortisol; TID-HC, 3-times-daily hydrocortisone; UFE, urinary free cortisone; UFF, urinary free cortisol.
a P value adjusted for age, sex, and weight using logistic regression.
bPeriod-adjusted P value.
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