Determination of Cortisol Peak Response Time in ACTH Stimulation Test
Yıl: 2021 Cilt: 43 Sayı: 1 Sayfa Aralığı: 46 - 49 Metin Dili: İngilizce DOI: 10.20515 / otd. 760378 İndeks Tarihi: 06-05-2021
Determination of Cortisol Peak Response Time in ACTH Stimulation Test
Öz: Adrenocorticotropic hormone (ACTH) stimulation test is widely used in diagnosis of adrenal insufficiency. Synthetic ACTH analogue has two formulations: Short-acting intravenous or intramuscular form and intramuscular depot form. In the standard ACTHstimulation test protocol, 250μg synthetic ACTH (1-24) is administered intravenously. Blood samples are then taken at 0, 30, 60 and90 minutes for cortisol. We aimed to determine the time of cortisol peak response by evaluating cortisol responses to intramusculardepot ACTH. Seventy patients who underwent ACTH stimulation test between October 2017 and February 2019 in Eskişehir Osmangazi University Endocrinology Department were included to the study. 250 mcg intramuscular depot ACTH was administeredbetween 08.00-09.00 a.m. Blood samples were taken before ACTH administration and at 30, 60, 120, 240 minutes. Cortisol levels18 mcg/dl and above was accepted as normal response. Since 20 mcg / dl and above are accepted as normal response in differentpublications, evaluation was also made on this value. The highest cortisol level was reached in 240 minutes in all patients. If normalcortisol response is accepted as 20 mcg/dl and above, 38 patients reached normal cortisol values at 30th minute, 12 patients at 60thminute, 6 patients at 120th minute. If normal cortisol response is accepted as 18 mcg/dl and above, 38 patients reached normalcortisol values at 30th minute, 10 patients reached normal cortisol values at 60th minute, 2 patients reached 120th minute. In bothgroups, only one patient was able to reach the target cortisol value after prolongation to 240 minutes. We suggest that prolongation ofthe stimulation test with intramuscular depot ACTH up to 120 minutes may prevent patients from being misdiagnosed with adrenalinsufficiency, but prolongation to 240 minutes will not provide additional benefit.
Anahtar Kelime: ACTH Uyarı Testinde Kortizol Pik Yanıtı Zamanının Belirlenmesi
Öz: Adrenal yetmezlik tanısında Adrenokortikotropik hormon (ACTH) stimülasyon testi yaygın olarak kullanılmaktadır. Sentetik ACTH analoğunun iki formülasyonu bulunmaktadır: intravenöz veya intramüsküler kullanımı için kısa etkili form ve intramüsküler kullanım için depo formu. Standart ACTH stimülasyon test protokolünde, 250μg sentetik ACTH (1-24) intravenöz uygulanır. Sonrasında 0, 30, 60 ve 90. dakikalarda kortizol için kan örnekleri alınır. Bu çalışmamızda intramüsküler uygulanan depo ACTH testine kortizol yanıtlarını değerlendirerek kortizol pik yanıtının zamanını belirlemeyi amaçladık. Çalışmaya Eskişehir Osmangazi Üniversitesi Endokrinoloji ve Metabolizma Hastalıkları Bilim Dalında Ekim 2017- Şubat 2019 tarihlerinde ACTH stimülasyon testi uygulanmış 70 hasta alındı. Hastalara 250 mcg depo ACTH 08.00-09.00 saatleri arasında intramuskuler olarak uygulandı. Kan örnekleri ACTH uygulaması öncesi ve 30, 60, 120 ve 240. dakikalarda alındı. Kortizol değeri 18 mcg/dl ve üzeri normal yanıt olarak kabul edildi. Farklı yayınlarda 20 mcg/dl ve üzeri de normal yanıt olarak kabul edildiğinden bu değer üzerinden de değerlendirme yapıldı. Hastaların hepsinde en yüksek kortizol seviyesine 240. dakikada ulaşıldı. Normal kortizol yanıtı 20 mcg/dl ve üzeri kabul edildiğinde 38 hasta 30. dakikada, 12 hasta 60. dakikada, 6 hasta 120. dakikada, normal kortizol değerine ulaştı. Normal kortizol yanıtı 18 ve üzeri kabul edildiğinde 38 hasta 30. dakikada, 10 hasta 60. dakikada, 2 hasta 120. dakikada normal kortizol değerine ulaştı. Her iki grupta da sadece birer hasta 240. dakikaya uzatıldığında hedef kortizol değerine ulaşabildi. Sonuç olarak intamüsküler uygulanan depo ACTH ile stimulasyon testinin 120. dakikaya kadar uzatılmasının hastaların yanlışlıkla adrenal yetmezlik tanısı almasını engelleyebileceği, 240. dakikaya kadar uzatılmasının ise ek fayda sağlamayacağı görüşündeyiz.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Alagüney E, Aydin Buyruk B, AKALIN A, Yorulmaz G (2021). Determination of Cortisol Peak Response Time in ACTH Stimulation Test. , 46 - 49. 10.20515 / otd. 760378 |
| Chicago | Alagüney Elif Sevil,Aydin Buyruk Betul,AKALIN AYSEN,Yorulmaz Goknur Determination of Cortisol Peak Response Time in ACTH Stimulation Test. (2021): 46 - 49. 10.20515 / otd. 760378 |
| MLA | Alagüney Elif Sevil,Aydin Buyruk Betul,AKALIN AYSEN,Yorulmaz Goknur Determination of Cortisol Peak Response Time in ACTH Stimulation Test. , 2021, ss.46 - 49. 10.20515 / otd. 760378 |
| AMA | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G Determination of Cortisol Peak Response Time in ACTH Stimulation Test. . 2021; 46 - 49. 10.20515 / otd. 760378 |
| Vancouver | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G Determination of Cortisol Peak Response Time in ACTH Stimulation Test. . 2021; 46 - 49. 10.20515 / otd. 760378 |
| IEEE | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G "Determination of Cortisol Peak Response Time in ACTH Stimulation Test." , ss.46 - 49, 2021. 10.20515 / otd. 760378 |
| ISNAD | Alagüney, Elif Sevil vd. "Determination of Cortisol Peak Response Time in ACTH Stimulation Test". (2021), 46-49. https://doi.org/10.20515 / otd. 760378 |
| APA | Alagüney E, Aydin Buyruk B, AKALIN A, Yorulmaz G (2021). Determination of Cortisol Peak Response Time in ACTH Stimulation Test. Osmangazi Tıp Dergisi, 43(1), 46 - 49. 10.20515 / otd. 760378 |
| Chicago | Alagüney Elif Sevil,Aydin Buyruk Betul,AKALIN AYSEN,Yorulmaz Goknur Determination of Cortisol Peak Response Time in ACTH Stimulation Test. Osmangazi Tıp Dergisi 43, no.1 (2021): 46 - 49. 10.20515 / otd. 760378 |
| MLA | Alagüney Elif Sevil,Aydin Buyruk Betul,AKALIN AYSEN,Yorulmaz Goknur Determination of Cortisol Peak Response Time in ACTH Stimulation Test. Osmangazi Tıp Dergisi, vol.43, no.1, 2021, ss.46 - 49. 10.20515 / otd. 760378 |
| AMA | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G Determination of Cortisol Peak Response Time in ACTH Stimulation Test. Osmangazi Tıp Dergisi. 2021; 43(1): 46 - 49. 10.20515 / otd. 760378 |
| Vancouver | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G Determination of Cortisol Peak Response Time in ACTH Stimulation Test. Osmangazi Tıp Dergisi. 2021; 43(1): 46 - 49. 10.20515 / otd. 760378 |
| IEEE | Alagüney E,Aydin Buyruk B,AKALIN A,Yorulmaz G "Determination of Cortisol Peak Response Time in ACTH Stimulation Test." Osmangazi Tıp Dergisi, 43, ss.46 - 49, 2021. 10.20515 / otd. 760378 |
| ISNAD | Alagüney, Elif Sevil vd. "Determination of Cortisol Peak Response Time in ACTH Stimulation Test". Osmangazi Tıp Dergisi 43/1 (2021), 46-49. https://doi.org/10.20515 / otd. 760378 |
