{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:23Z","timestamp":1787017943761,"version":"build-2736575974"},"reference-count":43,"publisher":"S. Karger AG","issue":"7","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuroendocrinology"],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Introduction: The present study aimed to prove the metyrapone short test in a day clinic to be suitable for examining the integrity of the hypothalamic-pituitary-adrenal (HPA) axis in patients with suspected secondary and tertiary adrenal insufficiency and to identify novel effector molecules in acute stress response. Methods: 44 patients were prospectively enrolled. Based on stimulated 11-deoxycortisol levels, patients were divided into a physiological (11-deoxycortisol \u226570 \u03bcg\/L) and a pathological (11-deoxycortisol &lt;70 \u03bcg\/L) response group. Clinical follow-up examination was performed for validation. Ultraperformance liquid chromatography tandem mass spectrometry and a Fourier-transform-ion-cyclotron-resonance-mass-spectrometry were used for targeted and untargeted steroid metabolomics. Results: At baseline, lower levels of cortisone (42 vs. 50 nmol\/L, p = 0.048) and 17-OH-progesterone (0.6 vs. 1.2 nmol\/L, p = 0.041) were noted in the pathological response group. After metyrapone administration, the pathological response group exhibited significantly lower 11-deoxycortisol (39.0 vs. 94.2 \u03bcg\/L, p &lt; 0.001) and ACTH (49 vs. 113 pg\/mL, p &lt; 0.001) concentrations as well as altered upstream metabolites. Untargeted metabolomics identified a total of 76 metabolites to be significantly up- or downregulated by metyrapone. A significant increase of the bile acid glycochenodeoxycholic acid (GCDC, p &lt; 0.01) was detected in both groups with an even stronger increase in the physiological response group. After a mean follow-up of 17.2 months, an 11-deoxycortisol cut-off of 70 \u00b5g\/L showed a high diagnostic performance (sensitivity 100%, specificity 96%). Conclusion: The metyrapone short test is safe and feasible in a day clinic setting. The alterations of the bile acid GCDC indicate that the liver might be involved in the acute stress response of the HPA axis.<\/jats:p>","DOI":"10.1159\/000529146","type":"journal-article","created":{"date-parts":[[2023,1,16]],"date-time":"2023-01-16T17:00:37Z","timestamp":1673888437000},"page":"770-784","source":"Crossref","is-referenced-by-count":7,"title":["A Prospective Analysis of the Metyrapone Short Test Using Targeted and Untargeted Metabolomics"],"prefix":"10.1159","volume":"113","author":[{"given":"Anna Katharina","family":"Seoudy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Schlicht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4411-6879","authenticated-orcid":false,"given":"Alexandra","family":"Kulle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Demetrowitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexia","family":"Beckmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2383-3596","authenticated-orcid":false,"given":"Corinna","family":"Geisler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathrin","family":"T\u00fcrk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9038-5845","authenticated-orcid":false,"given":"Nathalie","family":"Rohmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Brandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik M.","family":"Schulte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3943-0564","authenticated-orcid":false,"given":"Karin","family":"Schwarz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul-Martin","family":"Holterhus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Laudes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2023,1,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19040986"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fnbeh.2020.601939"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-021-00252-7"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1186\/s12902-016-0117-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-19-8-875"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1994.tb03011.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-29-7-985"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1211262"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1210\/jcem-40-2-290"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1210\/er.2003-0030"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2001-011959"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.125.3.472"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1980.tb01024.x"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1983.tb00580.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-117832"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1515\/jpem.1994.7.4.317"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2008-0154"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.143.12.2276"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1159\/000346406"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.D700041-JLR200"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.phytol.2016.11.006"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1111\/cen.13719"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgab096"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2009.04322.x"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaa008"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1700"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021897"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2007.03141.x"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2000.01093.x"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1979.tb02119.x"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2010.010167"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1530\/acta.0.1010062"},{"key":"ref33","doi-asserted-by":"publisher","DOI":"10.1056\/nejmra021561"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-0651"},{"key":"ref35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.06.034"},{"key":"ref36","doi-asserted-by":"publisher","DOI":"10.1097\/01.ccm.0000164541.12106.57"},{"key":"ref37","doi-asserted-by":"publisher","DOI":"10.1002\/cphy.c120027"},{"key":"ref38","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00660"},{"key":"ref39","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-45328-2_2"},{"key":"ref40","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2008.05.027"},{"key":"ref41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2018.09.024"},{"key":"ref42","doi-asserted-by":"publisher","DOI":"10.1186\/cc1517"},{"key":"ref43","doi-asserted-by":"publisher","DOI":"10.1038\/onc.2009.358"}],"container-title":["Neuroendocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/nen\/article-pdf\/113\/7\/770\/3957961\/000529146.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/nen\/article-pdf\/113\/7\/770\/3957961\/000529146.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:10:55Z","timestamp":1745406655000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000529146"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":43,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7,3]]},"published-print":{"date-parts":[[2023,7,4]]}},"URL":"https:\/\/doi.org\/10.1159\/000529146","archive":["Portico"],"relation":{},"ISSN":["0028-3835","1423-0194"],"issn-type":[{"value":"0028-3835","type":"print"},{"value":"1423-0194","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023]]}}}