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The Ratio of 6β‐Hydroxycortisol to Cortisol in Urine as a Measure of Cytochrome P 450 3 A Activity in Postmortem Cases
Author(s) -
Lang Lotte M.,
Linnet Kristian
Publication year - 2014
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.12418
Subject(s) - urine , cirrhosis , endocrinology , cytochrome p450 , medicine , metabolic activity , cytochrome , metabolism , enzyme , biology , pharmacology , physiology , biochemistry
Abstract Poisoning can occur with chronic accumulation of a drug due to reduced metabolic capacity; conversely, under‐treatment may occur due to an increased metabolic rate. Over half of all drugs are metabolized by the cytochrome P 450 3 A complex ( CYP 3 A ). The activity of CYP 3 A can be assessed by the urinary ratio of 6β‐hydroxycortisol to cortisol. The aim of this study was to determine the usefulness of this ratio as a postmortem marker for determining whether altered CYP 3 A enzyme activity occurred prior to death. In a series of 244 postmortem cases, this ratio ranged from 0.014 to 78.6 (median 3.50). The median was significantly higher (5.14) in a subgroup of 28 cases that exhibited the presence of CYP 3 A ‐inducing drugs. In cirrhosis, the median ratio was 1.69. This pointed to a reduced metabolic capacity of CYP 3 A . Thus, the ratio may constitute a rough indicator of the CYP 3 A metabolic capacity, which could be of value in special cases.