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Table 5 Adrenal dysfunction of critical illness-related corticosteroid insufficiency on ACTH test day

From: Steroidogenesis in the adrenal dysfunction of critical illness: impact of etomidate

  Cortisol increase < 250 n M Cortisol increase ≥ 250 n M P
  Etomidate No etomidate Etomidate No etomidate C, E, E*C
  n = 8 n = 20 n = 6 n = 33  
ACTH, pM 2.8 (4.6) 4.0 (11) 1.1 (1.8) 2.5 (2.6) 0.02, 0.001, 0.27
Cholesterol, mM 1.6 (1.5) 1.6 (1.0) 1.4 (0.7) 2.5 (1.0) 0.03, 0.06, 0.07
HDL-cholesterol, mM 0.60 (0.30) 0.40 (0.40) 0.40 (0.50) 0.90 (0.50) 0.09, 0.13, 0.04
Progesterone, nM 0.90 (1.5) 0.70 (0.80) 0.40 (0.70) 0.60 (0.60) 0.63, 0.83, 0.39
Corticosterone, nM 2.6 (3.1) 4.3 (8.0) 6.0 (7.2) 3.3 (6.5) 0.71, 0.71, 0.06
Aldosterone, nM 0.90 (1.2) 0.90 (1.3) 1.5 (1.3) 1.0 (1.3) 0.34, 0.95, 0.90
17-OH-progesterone, nM 3.2 (2.3) 2.5 (2.4) 2.5 (3.2) 2.6 (1.5) 0.10, 0.16, 0.12
11ß-deoxycortisol, nM 25 (56) 2.8 (11) 17 (45) 2.0 (4.9) 0.26, 0.05, 0.50
Cortisol, nM 427 (192) 518 (294) 460 (230) 460 (310) 0.64, 0.70, 0.06
Cortisol/11ß-deoxycortisol 13 (139) 177 (400) 38 (170) 229 (372) 0.15, < 0.001, 0.96
Cortisol/ACTH 180 (120) 107 (154) 395 (376) 165 (227) < 0.001, < 0.001, 0.004
Cortisol increase, nM 121 (114) 180 (118) 280 (30) 440 (163) na, < 0.001, na
DHEA, μM 6.4 (2.6) 6.1 (5.6) 5.5 (4.1) 6.1 (3.9) 0.88, 0.48, 0.80
DHEAS, nM 1.0 (2.5) 0.48 (1.1) 0.55 (0.98) 0.59 (0.90) 0.55, 0.03, 0.16
Androstenedione, nM 3.7 (8.7) 2.9 (3.8) 3.6 (5.6) 2.2 (2.4) 0.23, 0.93, 0.19
  1. Median (interquartile range). ACTH, adrenocorticotropic hormone; C, low cortisol increase; CBG, cortisol-binding globulin; DHEA(S), dihydroxyepiandrostenedione (sulfate); E, etomidate; E*C, interaction between the two in generalized estimating equations; HDL, high-density lipoprotein; na, not applicable.