Adrenal Insufficiency, Liver Cirrhosis
Conditions
Brief summary
Patients with liver cirrhosis (LC) often exhibit fatigue, poor oral intake, and abdominal discomfort, which are the symptoms that are also shown in subjects with adrenal insufficiency (AI). Controversy exists upon over-diagnosis of adrenal insufficiency in patients with LC, because decreased albumin and/or cortisol binding protein lower total cortisol levels while free cortisol increases/or is preserved. The investigators assumed that measuring salivary cortisol or direct free cortisol using mass-spectrometry would provide a more accurate level of cortisol in LC patients. 50 patients with LC will be recruited and undergo a rapid ACTH stimulation test and their blood/ saliva will be collected and analyzed. The difference between serum free cortisol and total cortisol, as well as between salivary cortisol and total cortisol will be investigated to find the optimal way to diagnose AI in LC patients.
Interventions
DIAGNOSTIC_TESTrapid ACTH stimulation test
Take 2ml blood/saliva sample at baseline. Then, we will inject synacthen 250mcg IV to patients and collect 2ml blood/saliva after 30minutes and 60 minutes.
Sponsors
Korea Institute of Science and Technology
Seoul National University Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients diagnosed of liver cirrhosis
Exclusion criteria
* pregnant * history of getting surgery of pituitary resection or adrenalectomy * patients with diagnosis of pituitary adenoma or adrenal adenoma * patients take steroid within 3 months * patients take medication related to synthesis of steroid or cortisol binding protein within 3 months (i.e. ketoconazole, etomidate, sex hormone, oral contraceptive) * patients take albumin, free frozen plasma, terlipressin, glypressin within 1 month * patients with acute medical condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Difference between total cortisol, serum free cortisol, and salivary cortisol | baseline, 30 minutes / 60minutes after synacthen injection | Difference between total cortisol, serum free cortisol, and salivary cortisol |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Correlation between serum free cortisol, salivary cortisol and steroid profile | baseline, 30 minutes / 60minutes after synacthen injection | Correlation between serum free cortisol, salivary cortisol and steroid profile |
Countries
South Korea
Contacts
Primary ContactMin Jeong Park
Outcome results
None listed