A RAPID TEST OF ADRENOCORTICAL FUNCTION USING HOMACTID (SYNTHETIC αh1–28 ACTH)

1971 ◽  
Vol 67 (3) ◽  
pp. 470-472 ◽  
Author(s):  
D. F. Woodings ◽  
P. Young
Keyword(s):  
Plasma Cortisol ◽  
Rapid Test ◽  
Plasma Cortisol Level ◽  
Adrenocortical Function ◽  
Adrenocortical Insufficiency ◽  
Normal Response ◽  
Short Test ◽  
The Mean ◽  
Synthetic Polypeptide ◽  
Single Plasma

ABSTRACT As a short test of adrenocortical function, plasma cortisol values were determined before, and 15 and 30 minutes after, a single intravenous injection of 10 μg of a synthetic polypeptide αh1–28 ACTH (HOMACTID) given between 9 and 10 a. m. Its usefulness in a screening test to exclude primary adrenocortical insufficiency is suggested based on a single plasma corticosteroid concentration obtained 30 minutes after the HOMACTID injection, a normal response being a level of greater than 19 μg/100 ml at this time. In 30 control subjects the mean plasma cortisol level rose by 8.9 (± se 0.8) μg/100 ml at 15 minutes and 12.0 (± se 0.9) μg/100 ml at 30 minutes from a resting value of 15.5 (± se 1.1) μg/100 ml. HOMACTID can thus be used as a quick test of adrenal function in the same way as Synacthen®.

COMPARISON OF TESTS OF HYPOTHALAMO-PITUITARY-ADRENOCORTICAL FUNCTION IN PITUITARY DISEASE

1970 ◽  
Vol 48 (1) ◽  
pp. 47-54 ◽  
Author(s):  
J. W. H. DOAR ◽  
V. WYNN ◽  
P. J. WEBB
Keyword(s):  
Plasma Cortisol ◽  
Plasma Cortisol Level ◽  
Adrenocortical Function ◽  
Cortisol Response ◽  
Adrenocorticotrophic Hormone ◽  
Dynamic Tests ◽  
Pituitary Disease ◽  
Similar Information ◽  
Comparison Of Tests ◽  
Indirect Tests

SUMMARY The use of the resting plasma cortisol level, the diurnal plasma cortisol rhythm and plasma cortisol response to a maximal adrenocorticotrophic hormone (ACTH) infusion or insulin-induced hypoglycaemia as indirect tests of hypothalamo—pituitary—adrenocortical function was examined in a group of 27 patients with pituitary disease. While the first three tests provided similar information about hypothalamo—pituitary—adrenocortical function, the plasma cortisol response to insulin-induced hypoglycaemia did not provide further clinically useful information. Difficulties in interpretation of dynamic tests of hypothalamo—pituitary—adrenocortical function are discussed.

ADRENOCORTICAL FUNCTION IN THE AGED, ASSESSED BY THE RAPID CORTICOTROPHIN TEST (SYNACTHEN®)

1970 ◽  
Vol 64 (3) ◽  
pp. 410-414 ◽  
Author(s):  
B. Blichert-Toft ◽  
M. Blichert-Toft
Keyword(s):  
Plasma Cortisol ◽  
Age Groups ◽  
Plasma Cortisol Level ◽  
Cortisol Concentration ◽  
Adrenocortical Function ◽  
Adequate Response ◽  
Significant Difference ◽  
Young Subjects ◽  
Aged Subjects ◽  
Two Age Groups

ABSTRACT 15 aged subjects, average age 81 years, were exposed to maximum corticotrophin stimulation. A single intravenous dose of 250 μg Synacthen was administered, and the changes in the plasma cortisol level were measured over the next 4 hours. 10 young subjects were included as controls. Both absolutely and relatively, the aged showed a completely adequate response. The maximum rise in cortisol concentration was observed 120 min after stimulation and was amounted to 24 μg/100 ml in the aged and 20.2 μg/100 ml in the young subjects. A significant difference in the level of the stimulation curve in the two age groups could not be demonstrated. The question is discussed whether the uniform rise in the plasma cortisol concentration in the young and the aged can be taken to support the theory of a reduced cortisol synthesis in the latter group.

VASOPRESSIN TEST: DIAGNOSTIC INACCURACY IN EVALUATION OF HYPOTHALAMIC-PITUITARY-ADRENOCORTICAL AXIS

1978 ◽  
Vol 87 (1) ◽  
pp. 28-39 ◽  
Author(s):  
Seppo Leisti ◽  
Jaakko Perheentupa
Keyword(s):  
Plasma Cortisol ◽  
Insulin Response ◽  
Plasma Cortisol Level ◽  
Reference Series ◽  
Maximal Level ◽  
Normal Series ◽  
Accuracy And Precision ◽  
Cortisol Responses ◽  
Maximal Plasma ◽  
The Mean

ABSTRACT An im vasopressin test was given to 141 children and adolescents, 52 with normal HPA axis and 89 with evident or suspected defect of the axis, and repeated in 36 cases, to establish criteria of a normal response, and to examine the accuracy and precision of the responses. Comparisons were made with the responses to the 2-h ACTH, insulin and 3-h metyrapone test. The distributions of plasma cortisol levels and increments were positively skew, and a log transformation was made for appropriate statistical analysis. Maximal plasma cortisol level was positively and maximal increment negatively correlated with the basal level. In precision, the maximal level was superior to the maximal increment. Hence, a normal result was best defined by an area around the regression of maximal level on basal level in the normal series. The best single index of the response was the maximal level. A useful new method was introduced for quantitative comparison of plasma cortisol responses to different tests. The vasopressin test result was frequently normal in patients who, according to repeated insulin tests were ACTH-deficient. Furthermore, the 10 patients with organic expansive hypothalamic lesions had a mean vasopressin response, that was greater relative to the insulin response than that of the reference series. However, 3 of 21 patients with organic non-expansive hypothalamic disease gave a subnormal vasopressin response but a normal insulin response. Moreover, in isolated GH deficiency and after prednisone medication the mean vasopressin response was lower relative to the insulin response than in the reference series. Thus, this test is not reliable in screening for, or in anatomical diagnoses of ACTH deficiency.

A COMPARATIVE STUDY OF SERUM GROWTH HORMONE AND PLASMA CORTISOL LEVELS IN STIMULATION TESTS WITH INSULIN AND PROPRANOLOL-GLUCAGON

1975 ◽  
Vol 80 (1) ◽  
pp. 70-80 ◽  
Author(s):  
W. Andler ◽  
G. Biro ◽  
S. Bernasconi ◽  
G. Giovanelli
Keyword(s):  
Growth Hormone ◽  
Plasma Cortisol ◽  
Normal Growth ◽  
Poor Response ◽  
Adrenocortical Function ◽  
Insulin Stimulation ◽  
Normal Response ◽  
Maximum Increase ◽  
Serum Growth Hormone ◽  
Stimulation Tests

ABSTRACT Insulin and propranolol-glucagon stimulation tests were carried out on 28 children and 5 adolescents and the results of their growth hormone and plasma cortisol estimations were compared. Twenty-nine subjects with normal growth hormone reserves showed a mean maximum rise of 17.4 μU/ml of serum growth hormone in the insulin test whereas the intramuscular injection of glucagon after oral premedication with propranolol produced a rise of 38.5 μU/ml. Five subjects with normal growth hormone reserves showed a reduced hormone output in the insulin stimulation tests but normal response in the propranolol-glucagon stimulation tests. Only one subject showed a poor response in the propranolol-glucagon but normal response in the insulin stimulation test. In 30 subjects with normal adrenocortical function the mean maximum increase of plasma cortisol was 15.6 μU/ml in the insulin – and 14.9 μU/ml in the propranolol-glucagon stimulation tests, respectively. Both methods are suitable for studying the pituitary-adrenocortical interrelationships. The mechanism of the release of glucagon-induced growth hormone is not clear but the fall in blood glucose does not seem to play a major role in the process. A stress-like mechanism is equally unlikely because vegetative symptoms occurred only i a small number of subjects after intramuscular glucagon administration. It is possible that glucagon possesses a releasing-like mechanism which operates in the pituitary itself.

Cortisol and Aldosterone Excretion and Plasma Cortisol Concentrations in Normal and Obese Female Subjects

1972 ◽  
Vol 43 (2) ◽  
pp. 289-298 ◽  
Author(s):  
Margaret E. Hankin ◽  
Helen M. Theile ◽  
A. W. Steinbeck
Keyword(s):  
Plasma Cortisol ◽  
Adrenocortical Function ◽  
Adrenocortical Activity ◽  
Obese Female ◽  
Free Cortisol ◽  
Derivative Method ◽  
Obese Subjects ◽  
The Mean ◽  
And Control ◽  
Double Isotope

1. The 24 h urinary excretion of free cortisol and aldosterone-18-glucuronide has been studied in twenty-three control and twenty-three grossly obese subjects by a double-isotope-dilution derivative method. 2. Day-night variation of plasma and urinary cortisol has also been investigated. 3. The mean absolute steroid values were similar for the obese and non-obese subjects. 4. The 24 h urinary values for free cortisol expressed as μg/kg of body weight were significantly higher for the controls. 5. The majority of the obese and control subjects had a day-night variation of plasma cortisol. All subjects, with two exceptions, showed day-night variation of free cortisol in the urine. 6. It is suggested that the estimation of unconjugated cortisol in timed urinary collections could be useful for investigations of adrenocortical function. 7. The findings do not support the presence of increased adrenocortical activity in developed obesity.

ADRENOCORTICAL FUNCTION IN THE HORSE

1970 ◽  
Vol 48 (3) ◽  
pp. 319-335 ◽  
Author(s):  
V. H. T. JAMES ◽  
MARIAN W. HORNER ◽  
M. S. MOSS ◽  
A. E. RIPPON
Keyword(s):  
Diurnal Rhythm ◽  
Eosinophil Count ◽  
Small Amplitude ◽  
Plasma Cortisol ◽  
Mammalian Species ◽  
Significant Alteration ◽  
Adrenocortical Function ◽  
Equine Plasma ◽  
The Mean ◽  
Cortisol Levels

SUMMARY Evidence for the presence of cortisol and corticosterone in equine plasma and cortisol in equine urine is presented. The mean morning concentration of plasma cortisol was 7 μg/100 ml, and that of corticosterone 0·5 μg/100 ml. A diurnal rhythm of small amplitude was found. Administration of corticotrophin, induction of hypoglycaemia and surgery produced marked increases in plasma cortisol levels, but only small increases were seen after normal exercise. The changes in plasma cortisol were not invariably accompanied by significant alteration of the eosinophil count. It is concluded that the mechanisms of control of adrenocortical function in the horse are not dissimilar to those described for other mammalian species.

PITUITARY-ADRENAL RECOVERY FOLLOWING LONG-TERM CORTICOSTEROID THERAPY

1966 ◽  
Vol 51 (1) ◽  
pp. 63-70 ◽  
Author(s):  
P. F. Roe ◽  
D. M. Mitchell ◽  
G. W. Pennington
Keyword(s):  
Corticosteroid Therapy ◽  
Adrenocortical Function ◽  
Endocrine Disorders ◽  
Marked Rise ◽  
Underlying Condition ◽  
Normal Limits ◽  
Small Rise ◽  
The Mean ◽  
Corticosteroid Drugs

ABSTRACT Adrenocortical function was assessed in 20 patients receiving long-term corticosteroid drugs for a variety of non-endocrine disorders. In all cases plasma 17-hydroxycorticosteroids (17-OHCS) levels were within or above normal limits 48 hours after abruptly stopping their drugs and a further marked rise occurred in 7 patients given metyrapone for 24 h. Urinary 17-OHCS excretion did not show a parallel rise. Taking the group as a whole, a small rise in the mean output occurred 48 hours after stopping therapy, and a further slightly greater rise followed metyrapone. 3 patients had a relapse of their underlying condition during the test in spite of normal plasma and urinary 17-OHCS levels.

EARLY VARIATIONS OF PLASMA CORTISOL AFTER PULSE INTRAVENOUS INJECTION OF DIBUTYRYL CYCLIC ADENOSINE 3′,5′-MONOPHOSPHATE IN NORMAL SUBJECTS

1973 ◽  
Vol 72 (4) ◽  
pp. 753-761 ◽  
Author(s):  
Alberto Angeli ◽  
Giuseppe Boccuzzi ◽  
Roberto Frajria ◽  
Daniela Bisbocci ◽  
Franco Ceresa
Keyword(s):  
Intravenous Injection ◽  
Plasma Cortisol ◽  
Time Course ◽  
Healthy Adult ◽  
Normal Subjects ◽  
Adult Women ◽  
Healthy Women ◽  
Adrenal Steroidogenesis ◽  
The Mean ◽  
Zero Time

ABSTRACT 10 mg/kg of dibutyryl cyclic adenosine 3′,5′-monophosphate (Db-cAMP) was iv pulse injected into twelve healthy adult women. The plasma cortisol levels were determined as 11-OHCS at zero time and then at 2.5, 5, 7.5, 10, 15, 30, 60 and 180 min after the injection. The data were compared with those obtained at the corresponding times in two groups of eleven and seventeen healthy women after the injection of 250 ng and 250 μg of synthetic β-1-24 corticotrophin performed in the same manner as the injection of the nucleotide. The mean increments in plasma cortisol were significantly lower after Db-cAMP than after ACTH. Differences were noted by analyzing the time course of the responses. In the case of stimulation with Db-cAMP the 11-OHCS levels rose progressively to a maximum at 15–30 min. By contrast, a peak of plasma cortisol was evident in most cases within a few min after the injection of ACTH; after a fall, a later rise was then observed starting from 15 min. The differences in the plasma 11-OHCS responses after the two stimuli may also be of interest clinically for the investigation of some aspects of adrenal steroidogenesis.

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