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https://hdl.handle.net/20.500.14094/90004549
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2024-05-22
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90004549 (fulltext)
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メタデータID
90004549
アクセス権
open access
出版タイプ
Version of Record
タイトル
Multiple salivary cortisol Measurements are a Useful Tool to Optimize Metyrapone Treatment in Patients with cushing's syndromes Treatment: case Presentations
著者
Yoshida, Kenichi ; Fukuoka, Hidenori ; Odake, Yukiko ; Nakajima, Shinsuke ; Tachibana, Mariko ; Ito, Jun ; Hosokawa, Yusei ; Yamada, Tomoko ; Miura, Hiroshi ; Suematsu, Natsu ; Matsumoto, Ryusaku ; Bando, Hironori ; Suda, Kentaro ; Nishizawa, Hitoshi ; Iguchi, Genzo ; Ogawa, Wataru ; Takahashi, Yutaka
著者名
Yoshida, Kenichi
著者ID
A1463
研究者ID
1000080622068
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=7a6e73f7fe330695520e17560c007669
著者名
Fukuoka, Hidenori
福岡, 秀規
フクオカ, ヒデノリ
所属機関名
医学部附属病院
著者名
Odake, Yukiko
著者名
Nakajima, Shinsuke
著者名
Tachibana, Mariko
著者名
Ito, Jun
著者名
Hosokawa, Yusei
著者名
Yamada, Tomoko
著者名
Miura, Hiroshi
著者名
Suematsu, Natsu
著者名
Matsumoto, Ryusaku
著者名
Bando, Hironori
著者名
Suda, Kentaro
著者名
Nishizawa, Hitoshi
著者ID
A1364
研究者ID
1000060346260
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=10fb3ec672ab5679520e17560c007669
著者名
Iguchi, Genzo
井口, 元三
イグチ, ゲンゾウ
所属機関名
保健管理センター
著者ID
A1358
研究者ID
1000040294219
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=38228987a3a438c8520e17560c007669
著者名
Ogawa, Wataru
小川, 渉
オガワ, ワタル
所属機関名
医学研究科
著者ID
A0765
研究者ID
1000070301281
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=1e2f0489e85e908f520e17560c007669
著者名
Takahashi, Yutaka
高橋, 裕
タカハシ, ユタカ
所属機関名
医学研究科
収録物名
Frontiers in Endocrinology
巻(号)
8
ページ
375-375
出版者
Frontiers Media
刊行日
2018-01-11
公開日
2018-01-26
抄録
Measuring salivary cortisol is both convenient and non-invasive for patients; however, its usefulness as a marker for monitoring medical therapy has not yet been established. The aim of this study was to assess the utility of multiple salivary cortisol measurements in patients with Cushing's syndrome (CS) during medical therapy. Six patients with CS (three with cortisol-secreting adrenocortical adenoma and three with ACTH-secreting pituitary adenoma) were recruited. Samples for morning serum cortisol, urinary free cortisol (UFC), and multiple salivary cortisol levels were collected before and during metyrapone treatment. The area under the curve (AUC) and mean value (MV) of daily salivary cortisol levels were calculated. In five out of six patients, UFC were normalized; however, multiple salivary cortisol measurements revealed an impaired diurnal cortisol rhythm in these patients. To verify the usefulness of multiple salivary cortisol measurements, we performed a prospective case study of a patient in whom the excess secretion of cortisol was not controlled (UFC 211 μg/day) with 2,250 mg/day in four divided doses of metyrapone. Multiple measurements of salivary cortisol revealed that cortisol levels elevated before the next administration. Accordingly, we shortened the interval by increasing the number of administration from four to five times per day, with a slight increment of daily dose of 2,500 mg. These optimizations resulted in a drastic improvement of diurnal pattern as well as UFC level (101 μg/day). Changes in both the MV and AUC of salivary cortisol levels were more correlated with those in UFC levels (Correlation coefficient 0.75, p = 0.007, and 0.70, p = 0.017) than those in the morning serum cortisol levels (0.42, p = 0.200), indicating that multiple salivary cortisol measurements reflect more precisely the excess secretion of cortisol. Our preliminary data suggest that multiple salivary cortisol measurements can be a useful tool to visualize the diurnal cortisol rhythm and to determine the dose and timing of metyrapone during the treatment in patients with CS.
キーワード
Cushing's syndrome
salivary cortisol
metyrapone
diurnal rhythm
monitoring marker
カテゴリ
医学研究科
医学部附属病院
保健管理センター
学術雑誌論文
権利
This Document is Protected by copyright and was first published by Frontiers. All rights reserved. it is reproduced with permission. © 2018 Yoshida, Fukuoka, Odake, Nakajima, Tachibana, Ito, Hosokawa, Yamada, Miura, Suematsu, Matsumoto, Bando, Suda, Nishizawa, Iguchi, Ogawa and Takahashi.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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資源タイプ
journal article
言語
English (英語)
eISSN
1664-2392
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関連情報
DOI
https://doi.org/10.3389/fendo.2017.00375
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