Cortisol: ACTH ratio to test for primary hypoadrenalism: a pilot study
| العنوان: | Cortisol: ACTH ratio to test for primary hypoadrenalism: a pilot study |
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| المؤلفون: | Samuel D Vasikaran, James C.G. Doery, David Prentice, Nilika Wijeratne, Mark K V Lee |
| المصدر: | Postgraduate Medical Journal. 89:617-620 |
| بيانات النشر: | Oxford University Press (OUP), 2013. |
| سنة النشر: | 2013 |
| مصطلحات موضوعية: | Adult, Male, endocrine system, medicine.medical_specialty, Secondary Hypoadrenalism, Adolescent, Hydrocortisone, Pilot Projects, Gastroenterology, Diagnostic Techniques, Endocrine, Young Adult, Addison Disease, Adrenocorticotropic Hormone, Internal medicine, Humans, Medicine, Short synacthen test, Prospective cohort study, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Australia, Diagnostic test, Retrospective cohort study, General Medicine, Middle Aged, Plasma cortisol, Endocrinology, Female, business, hormones, hormone substitutes, and hormone antagonists, Primary hypoadrenalism, Hormone |
| الوصف: | Introduction A standard short Synacthen test (SST) is the conventional diagnostic test for primary hypoadrenalism. Measuring simultaneous plasma cortisol and adrenocorticotrophin hormone (ACTH) and using the cortisol: ACTH ratio as a first-line test may be safer and more convenient than performing a SST. Methods A retrospective study of 349 patients who had a SST with simultaneous baseline plasma cortisol and ACTH performed between 2005 and 2010 in two separate Australian health centres. The plasma cortisol: ACTH ratio was calculated for each patient and their final diagnosis was determined based on their SST result and a review of their clinical notes. Results Eighteen patients had primary hypoadrenalism, 46 patients had secondary hypoadrenalism and 285 patients had normal adrenal function. All the patients with primary hypoadrenalism had a plasma cortisol: ACTH ratio 3, while subjects with normal adrenal function had a cortisol: ACTH ratio >15. There was overlap in cortisol: ACTH ratios of patients with secondary hypoadrenalism and normal adrenal function. Conclusions Although the cortisol: ACTH ratio predicts primary hypoadrenalism, its value is limited to diagnosing primary hypoadrenalism as it does not distinguish secondary hypoadrenalism from normal adrenal function. Larger prospective studies that include patients with early primary hypoadrenalism are needed to confirm the reliability of plasma cortisol: ACTH ratio as a diagnostic test for primary hypoadrenalism. |
| تدمد: | 1469-0756 0032-5473 |
| DOI: | 10.1136/postgradmedj-2012-131723 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4965edaf2dbfdacf8dd16bf158f32dd2 https://doi.org/10.1136/postgradmedj-2012-131723 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....4965edaf2dbfdacf8dd16bf158f32dd2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14690756 00325473 |
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| DOI: | 10.1136/postgradmedj-2012-131723 |