Simultaneous measurements of urinary free cortisol and cortisone for the assessment of functional glucocorticoid activity.
Simultaneous measurements of urinary free cortisol and cortisone for the assessment of functional glucocorticoid activity.
复制标题
同时测量尿液中游离皮质醇和可的松，以评估功能性糖皮质激素活性。
作者：
T. Remer;C. Maser‐Gluth
临床实验室经常测量 24 小时尿液样本中的尿游离皮质醇 (UFF) 排泄，以评估功能性糖皮质激素活性 (fGcA)。 24 小时 UFF 排泄量可作为全天血液游离皮质醇浓度的综合测量 (1)。越来越多的证据表明，同时测量同一样品材料中的 1 种以上分析物将为接受或拒绝特定诊断带来更大的信心(2)(3)(4)。因此，在识别皮质醇增多症方面，例如在确诊的库欣综合征 (2) 和 1 型糖尿病 (4) 患者中，与单独使用 UFF 相比，同时测量 UFF 和尿游离可的松 (UFE) 具有明显的优势。 2 型 11β-羟基类固醇脱氢酶（一种在人肾中高度表达的酶，可将皮质醇灭活为可的松）活性的变化可能会混淆肾皮质醇输出 (UFF)。因此，通常肾脏 24 小时 UFE 排泄量约为 UFF(2)(3)(4) 的两倍。
最近的检查显示，以下关系的相关系数为 0.71……
Urinary free cortisol (UFF) excretion in 24-h urine samples is frequently measured in clinical laboratories to assess functional glucocorticoid activity (fGcA). The 24-h UFF excretion serves as an integrated measure of blood free cortisol concentrations during the entire day (1). Increasing evidence suggests that simultaneous measurements of more than 1 analyte in the same sample material will bring more confidence to the acceptance or rejection of specific diagnoses(2)(3)(4). Accordingly, clear advantages have been reported regarding the identification of hypercortisolism, e.g., in patients with confirmed Cushing syndrome(2) and type1 diabetes mellitus(4), with simultaneous measurements of UFF and urinary free cortisone (UFE) compared with UFF alone. Variations in activity of 11β-hydroxysteroid dehydrogenase type2, a highly expressed enzyme in the human kidney that inactivates cortisol to cortisone, can confound renal cortisol output (UFF). Accordingly, the usual renal 24-h UFE excretion is about twice that of UFF(2)(3)(4).
Recent examinations have shown a correlation coefficient of 0.71 for the relation …