Table 1.
Effect of Cosyntropin on Steroid Concentrations and Ratios in the AV and IVC
A. Steroid Concentrations in the AV and IVC | ||||||||
---|---|---|---|---|---|---|---|---|
Steroid | Precosyntropin | Postcosyntropin | Fold Change (Post/Pre) | |||||
AV (nmol/L) | IVC (nmol/L) | AV/IVC (P Value) | AV (nmol/L) | IVC (nmol/L) | AV/IVC (P Value) | AV (P Value) | IVC (P Value) | |
PregS | 100 [54–210] | 66 [26–84] | 1.9 (0.02) | 2996 [2563–4833] | 91 [66–161] | 32 (<0.0001) | 32 (<0.0001) | 1.7 (0.006) |
17OHPregS | 22 [11–41] | 6.0 [3.0–16] | 3.4 (0.0008) | 554 [422–840] | 16 [12–20] | 35 (<0.0001) | 29 (<0.0001) | 3.0 (0.002) |
DHEAS | 2374 [1772–3561] | 2187 [1351–3409] | 1.2 (0.3) | 4730 [2788–6514] | 2185 [1271–2882] | 2.2 (0.001) | 1.8 (0.02) | 1.0 (0.8) |
AdiolS | 330 [170–804] | 351 [185–773] | 1.0 (0.9) | 316 [179–753] | 322 [200–723] | 1.0 (>0.99) | 1.0 (>0.99) | 1.0 (0.9) |
Preg | 2.8 [1.8–4.0] | 1.3 [0.8–2.6] | 2.1 (0.003) | 1502 [1280–1900] | 2.6 [2.1–4.3] | 551 (<0.0001) | 578 (<0.0001) | 2.0 (0.0009) |
17OHPreg | 10 [6.7–25] | 0.9 [0.2–3.2] | 32 (<0.0001) | 2863 [2280–3542] | 7.7 [4.3–13] | 370 (<0.0001) | 267 (<0.0001) | 7.1 (<0.0001) |
DHEA | 36 [26–75] | 11 [3.5–20] | 5.0 (<0.0001) | 1725 [1304–3198] | 15 [5.3–30] | 134 (<0.0001) | 49 (<0.0001) | 1.3 (0.3) |
B. Steroid Ratios in the AV and IVC | ||||||||
---|---|---|---|---|---|---|---|---|
Steroid Ratios | Precosyntropin | Postcosyntropin | Fold Change (Post/Pre) | |||||
AV | IVC | AV/IVC (P Value) | AV | IVC | AV/IVC (P Value) | AV (P Value) | IVC (P Value) | |
PregS/Preg | 28 [14–49] | 41 [27–54] | 0.9 (0.2) | 2.2 [1.8–2.6] | 37 [27–47] | 0.06 (<0.0001) | 0.07 (<0.0001) | 0.9 (0.6) |
17OHPregS/17OHPreg | 1.4 [0.8–2.3] | 4.9 [2.3–32] | 0.3 (0.0002) | 0.2 [0.1–0.3] | 2.0 [1.4–5.2] | 0.08 (<0.0001) | 0.2 (<0.0001) | 0.4 (0.04) |
DHEAS/DHEA | 73 [38–92] | 223 [140–382] | 0.3 (<0.0001) | 2.5 [2.0–3.6] | 163 [120–263] | 0.01 (<0.0001) | 0.04 (<0.0001) | 0.7 (0.1) |
DHEAS/PregS | 24 [12–49] | 36 [28–62] | 0.7 (0.07) | 1.3 [0.8–2.7] | 22 [14–32] | 0.07 (<0.0001) | 0.05 (<0.0001) | 0.6 (0.003) |
DHEA/Preg | 13 [9.5–20] | 6.9 [4.6–9.1] | 1.9 (0.003) | 1.2 [0.7–1.9] | 4.4 [2.8–8.7] | 0.3 (<0.0001) | 0.1 (<0.0001) | 0.8 (0.1) |
LC-MS/MS was used to quantify the unconjugated Δ5 steroids and steroid sulfates in paired AV and the IVC before and after 10 to 30 minutes of cosyntropin administration (injected as a 0.125-mg bolus followed by a 0.125-mg/h continuous infusion). Data are expressed as median [interquartile range]. AV/IVC is expressed as median of individual ratios with [interquartile range]. Statistical significance was determined by paired t test (P < 0.05). To convert nmol/L to ng/dL, multiply by the following correction factors: Preg, 31.65; 17OHPreg, 33.25; DHEA, 28.84; PregS, 39.65; 17OHPregS, 41.25; DHEAS, 36.85; and AdiolS, 37.05.