Patients with liver cirrhosis (LC) often exhibit fatigue, poor oral intake, and abdominal discomfort, which are the symptoms that are also shown in subjects with adrenal insufficiency (AI). Controversy exists upon over-diagnosis of adrenal insufficiency in patients with LC, because decreased albumin and/or cortisol binding protein lower total cortisol levels while free cortisol increases/or is preserved. The investigators assumed that measuring salivary cortisol or direct free cortisol using mass-spectrometry would provide a more accurate level of cortisol in LC patients. 50 patients with LC will be recruited and undergo a rapid ACTH stimulation test and their blood/ saliva will be collected and analyzed. The difference between serum free cortisol and total cortisol, as well as between salivary cortisol and total cortisol will be investigated to find the optimal way to diagnose AI in LC patients.
Study Type
OBSERVATIONAL
Enrollment
50
Take 2ml blood/saliva sample at baseline. Then, we will inject synacthen 250mcg IV to patients and collect 2ml blood/saliva after 30minutes and 60 minutes.
Seoul National University Hospital
Seoul, South Korea
RECRUITINGDifference between total cortisol, serum free cortisol, and salivary cortisol
Difference between total cortisol, serum free cortisol, and salivary cortisol
Time frame: baseline, 30 minutes / 60minutes after synacthen injection
Correlation between serum free cortisol, salivary cortisol and steroid profile
Correlation between serum free cortisol, salivary cortisol and steroid profile
Time frame: baseline, 30 minutes / 60minutes after synacthen injection
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