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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.