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dc.contributor.authorSævik, Åse Bjorvatn
dc.contributor.authorÅkerman, Anna-Karin
dc.contributor.authorMethlie, Paal
dc.contributor.authorQuinkler, Marcus
dc.contributor.authorJørgensen, Anders Palmstrøm
dc.contributor.authorHøybye, Charlotte
dc.contributor.authorDebowska, Aleksandra
dc.contributor.authorNedrebø, Bjørn Gunnar
dc.contributor.authorDahle, Anne Lise
dc.contributor.authorCarlsen, Siri
dc.contributor.authorTomkowicz, Aneta
dc.contributor.authorSollid, Stina Therese
dc.contributor.authorNermoen, Ingrid
dc.contributor.authorGrønning, Kaja
dc.contributor.authorDahlqvist, Per
dc.contributor.authorGrimnes, Guri
dc.contributor.authorSkov, Jakob
dc.contributor.authorFinnes, Trine Elisabeth
dc.contributor.authorValland, Susanna Fonneland
dc.contributor.authorWahlberg, Jeanette
dc.contributor.authorHolte, Synnøve Emblem
dc.contributor.authorSimunkova, Katerina
dc.contributor.authorKämpe, Olle
dc.contributor.authorHusebye, Eystein Sverre
dc.contributor.authorBensing, Sophie
dc.contributor.authorØksnes, Marianne
dc.description.abstractDesign: Two-staged, cross-sectional clinical study in 17 centers (Norway, Sweden, and Germany). Residual glucocorticoid (GC) production was defined as quantifiable serum cortisol and 11-deoxycortisol and residual mineralocorticoid (MC) production as quantifiable serum aldosterone and corticosterone after > 18 hours of medication fasting. Corticosteroids were analyzed by liquid chromatography–tandem mass spectrometry. Clinical variables included frequency of adrenal crises and quality of life. Peak cortisol response was evaluated by a standard 250 µg cosyntropin test. Results: Fifty-eight (30.2%) of 192 patients had residual GC production, more common in men (n = 33; P < 0.002) and in shorter disease duration (median 6 [0-44] vs 13 [0-53] years; P < 0.001). Residual MC production was found in 26 (13.5%) patients and associated with shorter disease duration (median 5.5 [0.5-26.0] vs 13 [0-53] years; P < 0.004), lower fludrocortisone replacement dosage (median 0.075 [0.050-0.120] vs 0.100 [0.028-0.300] mg; P < 0.005), and higher plasma renin concentration (median 179 [22-915] vs 47.5 [0.6-658.0] mU/L; P < 0.001). There was no significant association between residual production and frequency of adrenal crises or quality of life. None had a normal cosyntropin response, but peak cortisol strongly correlated with unstimulated cortisol (r = 0.989; P < 0.001) and plasma adrenocorticotropic hormone (ACTH; r = –0.487; P < 0.001). Conclusion: In established AAD, one-third of the patients still produce GCs even decades after diagnosis. Residual production is more common in men and in patients with shorter disease duration but is not associated with adrenal crises or quality of life. (J Clin Endocrinol Metab 105: 1–12, 2020) Key words: Adrenal failure; adrenal steroids; Autoimmune Addison disease; cortisol; primary adrenal insufficiency; residual functionen_US
dc.publisherOxford University Pressen_US
dc.rightsNavngivelse 4.0 Internasjonal*
dc.titleResidual Corticosteroid Production in Autoimmune Addison Diseaseen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright Endocrine Society 2020.en_US
dc.source.journalJournal of Clinical Endocrinology and Metabolismen_US
dc.relation.projectNorges forskningsråd: 288022en_US
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism. 2020, 105 (7), 2430–2441.en_US

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Navngivelse 4.0 Internasjonal
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