Twenty-four hour urinary cortisol excretion and the metabolic syndrome in prednisolone-treated renal transplant recipientsde Vries, L. V., de Jong, W. H. A., Touw, D. J., Berger, S. P., Navis, G., Kema, I. P. & Bakker, S. J. L. 8-Sep-2017 In : Steroids. 127, p. 31-39 9 p.
Research output: Scientific - peer-review › Article
- Pharmacokinetics, Toxicology and Targeting
- Biopharmaceuticals, Discovery, Design and Delivery (BDDD)
- Groningen Research Institute for Asthma and COPD (GRIAC)
- Lifestyle Medicine (LM)
- Groningen Kidney Center (GKC)
- Vascular Ageing Programme (VAP)
- Guided Treatment in Optimal Selected Cancer Patients (GUTS)
- Groningen Institute for Organ Transplantation (GIOT)
Chronic prednisolone treatment in renal transplant recipients (RTR) causes metabolic abnormalities, which cluster in the metabolic syndrome (MS). It also suppresses the hypothalamic-pituitaryadrenal (HPA)-axis. We investigated whether HPA-axis suppression, as measured by 24h urinary cortisol excretion, is associated with presence of the MS and its individual components, in outpatient RTR with a functioning graft for >1year. Urinary cortisol was measured in 24h urine, using LC-MS/MS (LOQ 0.30nmol/L). We included 563 RTR (age 51±12years; 54% male) at median 6.0 [IQR, 2.6-11.5] years post-transplantation. MS was present in 439/563 RTR (78%). Median 24h urinary cortisol excretion was 2.0 [IQR, 0.9-5.1]nmol/24h. Twenty-four hour urinary cortisol excretion was independently associated with MS presence (OR=0.80 [95% CI, 0.66-0.98], P=0.02). It was also independently associated with bodyweight (st.β=-0.11, P=0.007), waist circumference (st.β=-0.10, P=0.01), BMI (st.β=-0.14, P=0.001), fasting triglycerides (st.β=-0.15, P=0.001), diabetes (st.β=-0.12, P=0.005), and number of antihypertensives used (st.β=-0.13, P=0.003). Suppressed HPA-axis activity, as reflected by decreased 24h urinary cortisol excretion, is associated with higher prevalence of MS and its individual components (i.e. central obesity, dyslipidemia, diabetes, hypertension) in prednisolone-treated RTR. Assessment of 24h urinary cortisol excretion by LC-MS/MS may be a tool to monitor metabolic side-effects of prednisolone in RTR.
|Number of pages||9|
|Early online date||8-Sep-2017|
|State||E-pub ahead of print - 8-Sep-2017|
- Journal Article