Evidence map›Paper›PMID 35449323›Full record

Observational studyEndocrine2022

Urinary free cortisol is a reliable index of adrenal cortisol production in patients with liver cirrhosis.

Maria Michailidou, Ioanna Aggeletopoulou, Maria Kouskoura, Konstantinos Zisimopoulos, Efthymios P Tsounis, Katerina Karaivazoglou, Evanthia Tourkochristou, Martha Mandellou, Georgia Diamantopoulou, Nikolaos Koutras and 6 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Endocrine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 37% 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

1 citing paper in PubMed, 5 citations in OpenAlex.

  1. Article
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

16 authors at 3 institutions in 1 country.

Maria MichailidouDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Ioanna AggeletopoulouDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Maria KouskouraLaboratory of Pharmaceutical Analysis, Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Konstantinos ZisimopoulosDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Efthymios P TsounisDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Katerina KaraivazoglouDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Evanthia TourkochristouDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Martha MandellouDepartment of Biochemistry, University Hospital of Patras, Patras, Greece.
Georgia DiamantopoulouDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Nikolaos KoutrasLaboratory of Pharmaceutical Analysis, Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Marina MichalakiDivision of Endocrinology, Diabetes and Metabolic Diseases, Department of Internal Medicine, University of Patras, Patras, Greece.
Charalampos GogosDepartment of Internal Medicine, University Hospital of Patras, Patras, Greece.
Dimitrios VelissarisDepartment of Internal Medicine, University Hospital of Patras, Patras, Greece.
Catherine K MarkopoulouLaboratory of Pharmaceutical Analysis, Department of Pharmaceutical Technology, School of Pharmacy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Konstantinos ThomopoulosDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece.
Christos TriantosDivision of Gastroenterology, Department of Internal Medicine, University Hospital of Patras, Patras, Greece. chtriantos@upatras.gr.ORCID 0000-0003-3094-8209
General University Hospital of Patras · GRAristotle University of Thessaloniki · GRUniversity of Patras · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe measurement of total and free cortisol has been studied as a clinical index of adrenal cortisol production in patients with liver cirrhosis. Correlations between free plasma and salivary cortisol have previously been reported in stable cirrhotic patients. Urinary free cortisol constitutes an index of adrenal cortisol production; however, it has never been used in assessing adrenal function in patients with liver cirrhosis.

aimsThe aim of this observational study was to determine associations between urinary free cortisol, serum total, salivary, measured and calculated plasma free cortisol levels in cirrhotics, determining which of them can be used as an indirect index of free cortisol levels. Moreover, we investigated the potential use of 24 h urinary free cortisol as a prognostic factor for mortality.

methodsSeventy-eight outpatients with liver cirrhosis were included. Serum, salivary and urinary free cortisol were measured using the electrochemiluminenscence immunoassay. Plasma free cortisol determination was conducted using a single quadrupole mass spectrometer. The quantification of free cortisol was achieved by determining the signal response on negative ESI-MS mode.

resultsTwenty-four hour urinary free cortisol levels correlated with free cortisol determined by mass spectrometer, total cortisol and calculated free cortisol levels. Patients with low levels of urinary free cortisol presented a significantly higher mortality rate compared to those with high levels. The factors associated with death risk were determined by Cox regression. In the multivariate analysis, two models were applied; in the first model, CP score, PVT and urinary free cortisol were found to be significantly related to patients' survival, whereas in the second, MELD score, ascites and urinary free cortisol were independently related to survival.

conclusionsThis study suggests that 24 h urinary free cortisol could be considered as a potential index of adrenal cortisol production in patients with liver cirrhosis and it potentially detects patients with a high mortality risk.

Indexed as

Adrenal InsufficiencyHydrocortisoneHumansLiver CirrhosisHydrocortisone24 h urinary free cortisolDecompensationLiver cirrhosisMortalityRelative adrenal insufficiency

Identifiers

PMID35449323
OpenAlexW4224279774

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.