Urinary free cortisone, but not cortisol, is associated with urine volume in severe obesity |
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Authors: | Karsten Müssig Andreas Fritsche Christiane Maser-Gluth |
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Institution: | a Division of Endocrinology, Diabetology, Angiology, Nephrology, and Clinical Chemistry, Department of Internal Medicine, University Hospital of Tübingen, Germany b Department of Nutrition and Health, Research Institute of Child Nutrition, Dortmund, Germany c Nutritional and Preventive Medicine, Department of Internal Medicine, University Hospital of Tübingen, Germany d Steroid Laboratory, Department of Pharmacology, University of Heidelberg, Germany |
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Abstract: | BackgroundHigh urine volume enhances urinary free cortisol (UFF) and cortisone (UFE) excretion rates in normal-weight adults and children. Renal excretion rates of glucocorticoids (GC) and their metabolites are frequently altered in obesity. The aim of the present study was to investigate whether UFF and UFE excretion is also affected by urine volume in severely obese subjects.ExperimentalIn 24-h urine samples of 59 extremely obese subjects (mean BMI 45.3 ± 8.9 kg/m2) and 20 healthy lean subjects (BMI 22.1 ± 1.8 kg/m2), UFF and UFE, tetrahydrocortisol (THF), 5α-tetrahydrocortisol (5α-THF), and tetrahydrocortisone (THE) were quantified by RIA. The sum of THF, 5α-THF, and THE (GC3), the three major GC metabolites, reflects daily cortisol secretion. 11β-Hydroxysteroid dehydrogenase type 2 (11β-HSD2) activity was assessed by the ratio UFE/UFF. Daily GC excretion rates were corrected for urine creatinine and adjusted for gender and body weight.ResultsIn extremely obese subjects, urine volume was significantly associated with creatinine-corrected UFE and 11β-HSD2 activity after adjustment for gender and BMI (r = 0.47, p = 0.0002 and r = 0.31, p = 0.02, respectively). However, urine volume was not associated with creatinine-corrected UFF and GC3 (p = 0.4 and p = 0.6, respectively). In lean controls, urine volume was significantly associated with creatinine-corrected UFE and UFF (r = 0.58, p = 0.01 and r = 0.55, p = 0.02, respectively), whereas urine volume was not associated with 11β-HSD2 activity after appropriate adjustment (p = 0.3).ConclusionsIn severe obesity, in contrast to normal weight, renal excretion of UFE, but not of UFF is affected by fluid intake. This discrepancy may be due to the increased renal 11β-HSD2 activity in obesity. |
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Keywords: | BP blood pressure BMI body mass index E cortisone F cortisol GC glucocorticoid GFR glomerular filtration rate 11β-HSD1 11β-hydroxysteroid dehydrogenase type 1 11β-HSD2 11β-hydroxysteroid dehydrogenase 2 IFG impaired fasting glucose IGT impaired glucose tolerance ISI insulin sensitivity index MDRD Modification of Diet in Renal Disease OGTT oral glucose tolerance test RIA radioimmunoassays THE tetrahydrocortisone THF tetrahydrocortisol 5α-THF 5α-tetrahydrocortisol TSH thyroid-stimulating hormone UFE urinary free cortisone UFF urinary free cortisol |
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