Evidence map›Paper›PMID 26999644›Full record

Trial reportEuropean journal of clinical investigation2016

Higher hydrocortisone dose increases bilirubin in hypopituitary patients- results from an RCT.

Jorien Werumeus Buning, Jenny E Kootstra-Ros, Pauline Brummelman, Gerrit van den Berg, Melanie van der Klauw, Bruce H R Wolffenbuttel, André P van Beek, Robin P F Dullaart

Erratum issued Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of clinical investigation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT01546992, which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01546992 no registry record found
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Jorien Werumeus BuningDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Jenny E Kootstra-RosLaboratory Center, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Pauline BrummelmanDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Gerrit van den BergDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Melanie van der KlauwDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Bruce H R WolffenbuttelDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
André P van BeekDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Robin P F DullaartDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NLUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBilirubin has anti-oxidative and anti-inflammatory properties, which may explain its proposed protective effects on the development of cardiometabolic disorders. Glucocorticoids affect heme oxygenase regulation in vitro, which plays a key role in bilirubin production. Effects of variations in glucocorticoid exposure on circulating bilirubin levels in humans are unknown. Here we tested whether a higher hydrocortisone replacement dose affects circulating bilirubin in hypopituitary patients. MATERIALS AND

methodsA randomized double-blind cross-over study (ClinicalTrials.gov, number NCT01546992) was performed in 47 patients with secondary adrenal failure [10-week exposure to a higher hydrocortisone dose (0·4-0·6 mg/kg body weight) vs. 10 weeks of a lower hydrocortisone dose (0·2-0·3 mg/kg body weight)].

resultsPlasma total bilirubin was increased by 10% from 7 to 8 μM in response to the higher hydrocortisone dose (P = 0·033). This effect was inversely related to age (P = 0·042), but was unaffected by sex, obesity and (replacement for) other hormonal insufficiencies. The higher hydrocortisone dose also resulted in lower alkaline phosphatase (P = 0·006) and aspartate aminotransferase activities (P = 0·001).

conclusionBilirubin is modestly increased in response to higher glucocorticoid exposure in humans, in conjunction with lower alkaline phosphatase and aspartate aminotransferase activities, which are supposed to represent biomarkers of a pro-inflammatory state and enhanced liver fat accumulation.

Indexed as

Adrenal InsufficiencyAdultAgedAlanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBilirubinCross-Over StudiesDouble-Blind MethodFemalegamma-GlutamyltransferaseGlucocorticoidsHormone Replacement TherapyHumansHydrocortisoneHypopituitarismAlanine TransaminaseAlkaline PhosphataseAspartate AminotransferasesBilirubingamma-GlutamyltransferaseGlucocorticoidsHydrocortisoneAlkaline phosphatasebilirubinhydrocortisonesecondary adrenal insufficiencytransaminases

Identifiers

PMID26999644
PMCPMC5111743
OpenAlexW2301257018

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.