Evidence map›Paper›PMID 34027338›Full record

ArticleJHEP reports : innovation in hepatology2021

Decreased maximal cortisol secretion rate in patients with cirrhosis: Relation to disease severity.

Christina M Lovato, Thierry Thévenot, Sophie Borot, Vincent Di Martino, Clifford R Qualls, Frank K Urban, Richard I Dorin

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.0field-weighted citation impact, top 24% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Article
  5. Overdiagnosis of adrenal insufficiency in children with biliary atresia.Clinical pediatric endocrinology : case reports and clinical investigations : official journal of the Japanese Society for Pediatric Endocrinology · 2023
    Article
  6. Article
  7. Adrenal Insufficiency in Cirrhosis.Journal of the Endocrine Society · 2022
    Review
  8. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Christina M LovatoDepartment of Internal Medicine/Endocrinology, Diabetes and Metabolism, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Thierry ThévenotService d'Hépatologie et de Soins Intensifs Digestifs, Hôpital Universitaire Jean Minjoz, Besançon, France.
Sophie BorotService d'Endocrinologie-Métabolisme et Diabétologie-Nutrition, Hôpital Jean Minjoz, Besançon, France.
Vincent Di MartinoService d'Hépatologie et de Soins Intensifs Digestifs, Hôpital Universitaire Jean Minjoz, Besançon, France.
Clifford R QuallsDepartment of Mathematics and Statistics, University of New Mexico, Albuquerque, NM, USA.
Frank K UrbanDepartment of Electrical and Computer Engineering, Florida International University, Miami, FL, USA.
Richard I DorinDepartment of Internal Medicine/Endocrinology, Diabetes and Metabolism, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Centre Hospitalier Universitaire de Besançon · FRUniversity of New Mexico · USFlorida International University · USHôpital Privé Jean Mermo · FRNew Mexico VA Health Care System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

aimsHepatic enzymes play a major role in the metabolic elimination of cortisol, and reduced rates of cortisol clearance have been consistently observed in patients with chronic liver disease. It is less clear whether there are concomitant abnormalities of adrenocortical function in patients with cirrhosis. In the present study, we sought to assess adrenocortical function in patients with cirrhosis using measures of free cortisol appearance and elimination rates that are independent of serum concentrations of cortisol binding proteins.

methods

resultsMaximal cortisol secretion rate (CSR

conclusionsCSR LAY SUMMARY: We applied numerical analytic methods to characterise adrenocortical function in patients with varying stages of chronic liver disease. We found that patients with more severe cirrhosis have decreased rate of free cortisol elimination and decreased maximal cortisol secretion rate, which is a measure of adrenocortical function. In contrast to conventional measures of adrenocortical function, those obtained using numerical methods were not affected by variation in corticosteroid binding globulin and albumin concentrations. We conclude that patients with cirrhosis demonstrate measurable abnormalities of adrenocortical function, evidence of which supports aspects of the hepatoadrenal syndrome hypothesis.

Indexed as

ACLF, acute-on-chronic liver failureACTH, adrenocorticotrophinAdrenal insufficiencyAI, adrenal insufficiencyCBG, corticosteroid-binding globulinCIRCI, critical illness-related corticosteroid insufficiencyComputer-assisted numerical analysisCP, Child-PughCPR, cortisol production rateCRP, C-reactive proteinCRT, corticosteroid replacement therapyCSRbase, basal CSR (before ACTH stimulation)CSR, cortisol secretion rateCSRmax, maximal CSRHPA, hypothalamic–pituitary–adrenalHSD, hydroxysteroid dehydrogenaseHydrocortisoneINR, international normalised ratioLiver diseaseMCR, metabolic clearance rateMELD, model for end-stage liver diseaseMetabolic clearance ratePAI, primary adrenal insufficiencyRAI, relative adrenal insufficiencyRCT, randomised clinical trialSAI, secondary adrenal insufficiencySCOTCH, Supplemental Corticosteroids in Cirrhotic Hypotensive Patients With Suspicion of SepsisSTB, standardised beta

Identifiers

PMID34027338
PMCPMC8121968
OpenAlexW3136888805

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.