{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T10:17:17Z","timestamp":1783937837819,"version":"3.55.0"},"reference-count":43,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T00:00:00Z","timestamp":1606262400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"publisher","award":["2015\u201302561"],"award-info":[{"award-number":["2015\u201302561"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish federal government under the LUA\/ALF agreement","award":["ALFGBG-719531"],"award-info":[{"award-number":["ALFGBG-719531"]}]},{"name":"Shire International GmbH","award":["SWE_000991"],"award-info":[{"award-number":["SWE_000991"]}]},{"DOI":"10.13039\/501100002915","name":"Fondation pour la Recherche M\u00e9dicale","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002915","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Oral once-daily dual-release hydrocortisone (DR-HC) replacement therapy has demonstrated an improved metabolic profile compared to conventional 3-times-daily (TID-HC) therapy among patients with primary adrenal insufficiency. This effect might be related to a more physiological cortisol profile, but also to a modified pattern of cortisol metabolism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aimed to study cortisol metabolism during DR-HC and TID-HC.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A randomized, 12-week, crossover study was conducted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Intervention and Participants<\/jats:title>\n                  <jats:p>DC-HC and same daily dose of TID-HC were administered to patients with primary adrenal insufficiency (n\u2005=\u200550) vs healthy individuals (n\u2005=\u2005124) as controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Urinary corticosteroid metabolites were measured by gas chromatography\/mass spectrometry at 24-hour urinary collections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Total cortisol metabolites decreased during DR-HC compared to TID-HC (P\u2005&amp;lt;\u2005.001) and reached control values (P\u2005=\u2005.089). During DR-HC, 11\u03b2-hydroxysteroid dehydrogenase type 1 (11\u03b2-HSD1) activity measured by tetrahydrocortisol\u2005+\u20055\u03b1-tetrahydrocortisol\/tetrahydrocortisone ratio was reduced compared to TID-HC (P\u2005&amp;lt;\u2005.05), but remained increased vs controls (P\u2005&amp;lt;\u2005.001). 11\u03b2-HSD2 activity measured by urinary free cortisone\/free cortisol ratio was decreased with TID-HC vs controls (P\u2005&amp;lt;\u2005.01) but normalized with DR-HC (P\u2005=\u2005.358). 5\u03b1- and 5\u03b2-reduced metabolites were decreased with DR-HC compared to TID-HC. Tetrahydrocortisol\/5\u03b1-tetrahydrocortisol ratio was increased during both treatments, suggesting increased 5\u03b2-reductase activity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The urinary cortisol metabolome shows striking abnormalities in patients receiving conventional TID-HC replacement therapy, with increased 11\u03b2-HSD1 activity that may account for the unfavorable metabolic phenotype in primary adrenal insufficiency. Its change toward normalization with DR-HC may mediate beneficial metabolic effects. The urinary cortisol metabolome may serve as a tool to assess optimal cortisol replacement therapy.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa862","type":"journal-article","created":{"date-parts":[[2020,11,25]],"date-time":"2020-11-25T08:51:03Z","timestamp":1606294263000},"page":"814-825","source":"Crossref","is-referenced-by-count":13,"title":["Improved Urinary Cortisol Metabolome in Addison Disease: A Prospective Trial of Dual-Release Hydrocortisone"],"prefix":"10.1210","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9584-4294","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Espiard","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"McQueen","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4078-624X","authenticated-orcid":false,"given":"Mark","family":"Sherlock","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Beaumont Hospital and Royal College of Surgeons in Ireland, Co. Dublin 9, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0204-9492","authenticated-orcid":false,"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9535-8632","authenticated-orcid":false,"given":"Ragnhildur","family":"Bergthorsdottir","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4844-8336","authenticated-orcid":false,"given":"Pia","family":"Burman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sk\u00e5ne University Hospital Malm\u00f6, Malm\u00f6 and University of Lund, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6471-9503","authenticated-orcid":false,"given":"Per","family":"Dahlqvist","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Ekman","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Department of Medical and Health Sciences, Department of Clinical and Experimental Medicine, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt Ed\u00e9n","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Endocrinology and Metabolism, Uppsala University Hospital, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanko","family":"Skrtic","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"AstraZeneca R&D, M\u00f6lndal, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Wahlberg","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Department of Medical and Health Sciences, Department of Clinical and Experimental Medicine, Link\u00f6ping University, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M","family":"Stewart","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, University of Leeds, Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3484-8440","authenticated-orcid":false,"given":"Gudmundur","family":"Johannsson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Sahlgrenska University Hospital and Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2020,11,24]]},"reference":[{"issue":"6181","key":"2021122117335447400_CIT0001","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1136\/bmj.2.6181.25","article-title":"Addison\u2019s disease","volume":"2","author":"Swyer","year":"1979","journal-title":"Br Med J."},{"issue":"1","key":"2021122117335447400_CIT0002","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/cen.12603","article-title":"Adrenal insufficiency: review of clinical outcomes with current glucocorticoid replacement therapy","volume":"82","author":"Johannsson","year":"2015","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"5","key":"2021122117335447400_CIT0003","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1111\/j.1365-2265.2008.03340.x","article-title":"Increased death risk and altered cancer incidence pattern in patients with isolated or combined autoimmune primary adrenocortical insufficiency","volume":"69","author":"Bensing","year":"2008","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"12","key":"2021122117335447400_CIT0004","doi-asserted-by":"crossref","first-page":"4849","DOI":"10.1210\/jc.2006-0076","article-title":"Premature mortality in patients with Addison\u2019s disease: a population-based study","volume":"91","author":"Bergthorsdottir","year":"2006","journal-title":"J Clin Endocrinol Metab."},{"issue":"9254","key":"2021122117335447400_CIT0005","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/S0140-6736(00)04006-X","article-title":"Association between premature mortality and hypopituitarism. West Midlands Prospective Hypopituitary Study Group","volume":"357","author":"Tomlinson","year":"2001","journal-title":"Lancet."},{"issue":"4","key":"2021122117335447400_CIT0006","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1210\/jc.2012-4059","article-title":"Deaths among adult patients with hypopituitarism: hypocortisolism during acute stress, and de novo malignant brain tumors contribute to an increased mortality","volume":"98","author":"Burman","year":"2013","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122117335447400_CIT0007","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s12020-010-9359-8","article-title":"Co-morbidities, management and clinical outcome of auto-immune Addison\u2019s disease","volume":"38","author":"Leelarathna","year":"2010","journal-title":"Endocrine."},{"issue":"11","key":"2021122117335447400_CIT0008","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1007\/BF03345773","article-title":"Metabolic and cardiovascular profile in patients with Addison\u2019s disease under conventional glucocorticoid replacement","volume":"32","author":"Giordano","year":"2009","journal-title":"J Endocrinol Invest."},{"issue":"11","key":"2021122117335447400_CIT0009","doi-asserted-by":"crossref","first-page":"4264","DOI":"10.1210\/jc.2017-01324","article-title":"Visceral fat and novel biomarkers of cardiovascular disease in patients with Addison\u2019s disease: a case-control study","volume":"102","author":"Bergthorsdottir","year":"2017","journal-title":"J Clin Endocrinol Metab."},{"issue":"10","key":"2021122117335447400_CIT0010","doi-asserted-by":"crossref","first-page":"3954","DOI":"10.1210\/jc.2006-0524","article-title":"The impact of glucocorticoid replacement regimens on metabolic outcome and comorbidity in hypopituitary patients","volume":"91","author":"Filipsson","year":"2006","journal-title":"J Clin Endocrinol Metab."},{"issue":"3","key":"2021122117335447400_CIT0011","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S2213-8587(17)30398-4","article-title":"Effect of once-daily, modified-release hydrocortisone versus standard glucocorticoid therapy on metabolism and innate immunity in patients with adrenal insufficiency (DREAM): a single-blind, randomised controlled trial","volume":"6","author":"Isidori","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"issue":"3","key":"2021122117335447400_CIT0012","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/cen.13267","article-title":"Management of glucocorticoid replacement in adrenal insufficiency shows notable heterogeneity\u2014data from the EU-AIR","volume":"86","author":"Murray","year":"2017","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"3","key":"2021122117335447400_CIT0013","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1007\/s11102-008-0126-2","article-title":"Correction of cortisol overreplacement ameliorates morbidities in patients with hypopituitarism: a pilot study","volume":"11","author":"Danilowicz","year":"2008","journal-title":"Pituitary."},{"issue":"5","key":"2021122117335447400_CIT0014","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1111\/j.1365-2265.1995.tb02928.x","article-title":"Cardiovascular function and glucocorticoid replacement in patients with hypopituitarism","volume":"43","author":"Dunne","year":"1995","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"9","key":"2021122117335447400_CIT0015","first-page":"3082","article-title":"Metabolic effects of short-term elevations of plasma cortisol are more pronounced in the evening than in the morning","volume":"84","author":"Plat","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"issue":"11","key":"2021122117335447400_CIT0016","doi-asserted-by":"crossref","first-page":"4149","DOI":"10.1210\/jc.2014-2433","article-title":"Continuous subcutaneous hydrocortisone infusion therapy in Addison\u2019s disease: a randomized, placebo-controlled clinical trial","volume":"99","author":"Gagliardi","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122117335447400_CIT0017","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/cen.12670","article-title":"Circadian hormone profiles and insulin sensitivity in patients with Addison\u2019s disease: a comparison of continuous subcutaneous hydrocortisone infusion with conventional glucocorticoid replacement therapy","volume":"83","author":"Bj\u00f6rnsdottir","year":"2015","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"5","key":"2021122117335447400_CIT0018","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1210\/jc.2013-4253","article-title":"Continuous subcutaneous hydrocortisone infusion versus oral hydrocortisone replacement for treatment of Addison\u2019s disease: a randomized clinical trial","volume":"99","author":"Oksnes","year":"2014","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122117335447400_CIT0019","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1530\/EJE-09-0170","article-title":"Improving glucocorticoid replacement therapy using a novel modified-release hydrocortisone tablet: a pharmacokinetic study","volume":"161","author":"Johannsson","year":"2009","journal-title":"Eur J Endocrinol."},{"issue":"1","key":"2021122117335447400_CIT0020","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1530\/EJE-15-1212","article-title":"Achieving a physiological cortisol profile with once-daily dual-release hydrocortisone: a pharmacokinetic study","volume":"175","author":"Johannsson","year":"2016","journal-title":"Eur J Endocrinol."},{"issue":"1","key":"2021122117335447400_CIT0021","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1111\/j.1365-2265.2007.03011.x","article-title":"Modified-release hydrocortisone for circadian therapy: a proof-of-principle study in dexamethasone-suppressed normal volunteers","volume":"68","author":"Newell-Price","year":"2008","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"4","key":"2021122117335447400_CIT0022","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/cen.12316","article-title":"An oral multiparticulate, modified-release, hydrocortisone replacement therapy that provides physiological cortisol exposure","volume":"80","author":"Whitaker","year":"2014","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"2","key":"2021122117335447400_CIT0023","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1210\/jc.2011-1926","article-title":"Improved cortisol exposure-time profile and outcome in patients with adrenal insufficiency: a prospective randomized trial of a novel hydrocortisone dual-release formulation","volume":"97","author":"Johannsson","year":"2012","journal-title":"J Clin Endocrinol Metab."},{"issue":"2","key":"2021122117335447400_CIT0024","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1007\/s12020-015-0681-z","article-title":"Improvement of anthropometric and metabolic parameters, and quality of life following treatment with dual-release hydrocortisone in patients with Addison\u2019s disease","volume":"51","author":"Giordano","year":"2016","journal-title":"Endocrine."},{"issue":"5","key":"2021122117335447400_CIT0025","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1530\/EJE-14-1114","article-title":"Modified-release hydrocortisone decreases BMI and HbA1c in patients with primary and secondary adrenal insufficiency","volume":"172","author":"Quinkler","year":"2015","journal-title":"Eur J Endocrinol."},{"issue":"3","key":"2021122117335447400_CIT0026","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1152\/physrev.00020.2012","article-title":"11\u03b2-hydroxysteroid dehydrogenases: intracellular gate-keepers of tissue glucocorticoid action","volume":"93","author":"Chapman","year":"2013","journal-title":"Physiol Rev."},{"issue":"11","key":"2021122117335447400_CIT0027","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/0039-128X(90)90087-R","article-title":"Human hepatic cortisol reductase activities: enzymatic properties and substrate specificities of cytosolic cortisol delta 4-5 beta-reductase and dihydrocortisol-3 alpha-oxidoreductase(s)","volume":"55","author":"Iyer","year":"1990","journal-title":"Steroids."},{"issue":"2","key":"2021122117335447400_CIT0028","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1530\/JOE-11-0318","article-title":"5\u03b1-reduced glucocorticoids: a story of natural selection","volume":"212","author":"Nixon","year":"2012","journal-title":"J Endocrinol."},{"issue":"7","key":"2021122117335447400_CIT0029","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1210\/jc.2015-1516","article-title":"Gender-specific differences in skeletal muscle 11\u03b2-HSD1 expression across healthy aging","volume":"100","author":"Hassan-Smith","year":"2015","journal-title":"J Clin Endocrinol Metab."},{"issue":"3-5","key":"2021122117335447400_CIT0030","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1016\/j.jsbmb.2010.04.010","article-title":"Gas chromatography\/mass spectrometry (GC\/MS) remains a pre-eminent discovery tool in clinical steroid investigations even in the era of fast liquid chromatography tandem mass spectrometry (LC\/MS\/MS)","volume":"121","author":"Krone","year":"2010","journal-title":"J Steroid Biochem Mol Biol."},{"issue":"3","key":"2021122117335447400_CIT0031","first-page":"1022","article-title":"Cortisol metabolism in human obesity: impaired cortisone\u2013&gt;cortisol conversion in subjects with central adiposity","volume":"84","author":"Stewart","year":"1999","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122117335447400_CIT0032","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/BF03343803","article-title":"Congenital deficiency of 11\u03b2-hydroxysteroid dehydrogenase (apparent mineralocorticoid excess syndrome): diagnostic value of urinary free cortisol and cortisone","volume":"24","author":"Palermo","year":"2001","journal-title":"J Endocrinol Invest."},{"issue":"10","key":"2021122117335447400_CIT0033","doi-asserted-by":"crossref","first-page":"3827","DOI":"10.1210\/jc.2008-0743","article-title":"Steroid biomarkers and genetic studies reveal inactivating mutations in hexose-6-phosphate dehydrogenase in patients with cortisone reductase deficiency","volume":"93","author":"Lavery","year":"2008","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2021122117335447400_CIT0034","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1210\/jc.2014-4120","article-title":"Tissue specific regulation of glucocorticoids in severe obesity and the response to significant weight loss following bariatric surgery (BARICORT)","volume":"100","author":"Woods","year":"2015","journal-title":"J Clin Endocrinol Metab."},{"issue":"5","key":"2021122117335447400_CIT0035","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1530\/EJE-15-0490","article-title":"The modulation of corticosteroid metabolism by hydrocortisone therapy in patients with hypopituitarism increases tissue glucocorticoid exposure","volume":"173","author":"Sherlock","year":"2015","journal-title":"Eur J Endocrinol."},{"issue":"9","key":"2021122117335447400_CIT0036","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1124\/dmd.30.9.1029","article-title":"Glucocorticoid-mediated induction of CYP3A4 is decreased by disruption of a protein: DNA interaction distinct from the pregnane X receptor response element","volume":"30","author":"El-Sankary","year":"2002","journal-title":"Drug Metab Dispos."},{"issue":"10","key":"2021122117335447400_CIT0037","doi-asserted-by":"crossref","first-page":"4924","DOI":"10.1210\/jc.2003-030596","article-title":"Body fat distribution and cortisol metabolism in healthy men: enhanced 5\u03b2-reductase and lower cortisol\/cortisone metabolite ratios in men with fatty liver","volume":"88","author":"Westerbacka","year":"2003","journal-title":"J Clin Endocrinol Metab."},{"issue":"3","key":"2021122117335447400_CIT0038","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1007\/BF03346454","article-title":"Increased clearance of cortisol by 5\u03b2-reductase in a subgroup of women with adrenal hyperandrogenism in polycystic ovary syndrome","volume":"32","author":"Gambineri","year":"2009","journal-title":"J Endocrinol Invest."},{"key":"2021122117335447400_CIT0039","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.mce.2017.10.005","article-title":"Dysregulation of \u03944-3-oxosteroid 5\u03b2-reductase in diabetic patients: implications and mechanisms","volume":"470","author":"Valanejad","year":"2018","journal-title":"Mol Cell Endocrinol."},{"key":"2021122117335447400_CIT0040","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.metabol.2019.153947","article-title":"AKR1D1 is a novel regulator of metabolic phenotype in human hepatocytes and is dysregulated in non-alcoholic fatty liver disease","volume":"99","author":"Nikolaou","year":"2019","journal-title":"Metabolism."},{"key":"2021122117335447400_CIT0041","first-page":"EP730","article-title":"Gender specific metabolic phenotype in the 5\u03b2-reductase knockout mouse.","volume-title":"19th European Congress of Endocrinology;","author":"Gathercole","year":"2017"},{"issue":"4","key":"2021122117335447400_CIT0042","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/ijo.2009.4","article-title":"Expression of cortisol metabolism-related genes shows circadian rhythmic patterns in human adipose tissue","volume":"33","author":"Hernandez-Morante","year":"2009","journal-title":"Int J Obes (Lond)."},{"issue":"6","key":"2021122117335447400_CIT0043","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1517\/17425255.4.6.749","article-title":"Replacement therapy of oral hydrocortisone in adrenal insufficiency: the influence of gastrointestinal factors","volume":"4","author":"Lennern\u00e4s","year":"2008","journal-title":"Expert Opin Drug Metab Toxicol."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa862\/35196270\/dgaa862.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/3\/814\/41832795\/dgaa862.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/106\/3\/814\/41832795\/dgaa862.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T17:54:29Z","timestamp":1640109269000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/106\/3\/814\/6000448"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,24]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,11,24]]},"published-print":{"date-parts":[[2021,3,8]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa862","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,3,1]]},"published":{"date-parts":[[2020,11,24]]}}}