Diurnal Variation of 6β-Hydroxycortisol in Cardiac Patients

The 24-hour urinary excretion of 6-β-hydroxycortisol (6β-OHC) and the urinary ratio of 6β-hydroxycortisol/cortisol (6β-OHC/UFC) have been proposed as noninvasive probes for human cytochrome P450 3A4 isoform (CYP3A4). In this study, we evaluated withinand between-day variability of 6β-OHC excretion and 6β-OHC/UFC ratio in nine Caucasian men with cardiac disease. Each study participant was asked to collect 24-hour urine specimens during four consecutive days in five standardized time intervals. Concentrations of UFC and 6β-OHC were determined by immunoassay and the high-performance liquid chromatographic (HPLC) method, respectively. The HPLC method was accurate and precise, as indicated by the recovery rate of 96.5-103.3 % and less than 5.2 % and 6.3 % of the coefficient of variation for within-run and between-run assay, respectively. In patients, diurnal variations in UFC and 6β-OHC excretion were parallel. Consequently, 6β-OHC/UFC ratio remained stable during the day. Both, 6β-OHC excretion and 6β-OHC/UFC ratio showed significant relationship between 24-hour value and values measured in corresponding collection periods with best correlations obtained from night interval (22.00-06.00, r = 0.86-0.91). These results indicated that urinary 6β-OHC excretion and 6β-OHC/UFC ratio measured in overnight/morning urine could precisely reflect 24-hour values even in severely ill patients. In addition, a simple and sensitive HPLC method was described for determination of 6β-OHC in urine.