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Comprehensive study of urinary cortisol metabolites in hyperthyroid and hypothyroid patients
Author(s) -
Hoshiro M.,
Ohno Y.,
Masaki H.,
Iwase H.,
Aoki N.
Publication year - 2006
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/j.1365-2265.2005.02412.x
Subject(s) - medicine , endocrinology , urinary system , urine , cortisone , thyroiditis , thyroid function , thyroid
Summary Objective To further analyse the significance and mutual relationship of thyroid function‐linked alterations in cortisol metabolism that have been separately and variously reported. Patients and measurements Twenty‐four‐hour urine samples from 21 patients with hyperthyroidism (Graves’ disease), 16 patients with hypothyroidism (Hashimoto's thyroiditis), 21 healthy age‐ and sex‐matched controls for hyperthyroidism, and 16 healthy age‐ and sex‐matched controls for hypothyroidism were evaluated for 6β‐hydroxycortisol (6β‐OHF), tetrahydrocortisol (THF), tetrahydrocortisone (THE), allo‐tetrahydrocortisol (allo‐THF), urinary free cortisol (UFF), urinary free cortisone (UFE) and 17‐hydroxycorticosteroid (17‐OHCS). Results Urinary 17‐OHCS, THE and allo‐THF levels increased considerably in hyperthyroid patients compared to the controls, while UFF and THF showed no difference between the two groups. Urinary 6β‐OHF was significantly lower in the hyperthyroid patients than in the controls. Both the urinary allo‐THF + THF/THE and the UFF/UFE ratios were significantly lower in the hyperthyroid patients than in the controls, whereas only the former was significantly higher in the hypothyroid patients than in the controls. The urinary allo‐THF/THF ratio was significantly higher in the hyperthyroid patients and significantly lower in the hypothyroid patients than in the controls. In an analysis of pooled subjects including all groups ( n = 64), free T4 levels correlated negatively ( P < 0·0001) with the urinary allo‐THF + THF/THE ratio but not with the UFF/UFE ratio. The serum levels of free T4 correlated positively ( P < 0·0001) with the urinary allo‐THF/THF ratio. Conclusion The thyroid hormones seem to affect the total 11β‐HSD activity (allo‐THF + THF/THE) more strongly than the renal 11β‐HSD2 activity (UFF/UFE). 5α‐reductase activity (allo‐THF/THF) is also enhanced in hyperthyroidism, while the reduction of urinary 6β‐OHF in hyperthyroidism might be a secondary effect of the altered activity of the total 11β‐HSD and 5α‐reductase.