Abstract:
OBJECTIVE:The intravenous low-dose ACTH test has been proposed as a sensitive tool to assess adrenal function through circulating steroids. The aims of this study were to: (a) find the minimal intramuscular ACTH dose that induced serum and salivary cortisol and aldosterone responses equivalent to those obtained after a pharmacological dose of ACTH; and (b) define the minimum normal salivary cortisol and aldosterone responses in healthy subjects to that dose of ACTH. We also compared the performances of the standard- and low-dose ACTH intramuscular tests to screen patients with known hypothalamo-pituitary-adrenal impairments. DESIGN:Rapid ACTH tests were performed in individuals using various intramuscular doses (12.5, 25 and 250 microg) at 2-week intervals. SUBJECTS:Twenty-one healthy volunteers and 19 patients with primary (nine cases) and secondary (10 cases) adrenal insufficiency. MEASUREMENT:Serum and salivary cortisol and aldosterone concentrations were measured at baseline and after ACTH. Serum cortisol > or = 552.0 nmol/l and aldosterone > or = 555.0 pmol/l concentrations at 30 min after 250 microg of ACTH were defined as normal responses. RESULTS:In healthy volunteers cortisol and aldosterone responded to ACTH in a dose-dependent manner. The time to peak in saliva for each steroid was delayed as the dose of ACTH increased. The minimum ACTH dose that produced equivalent steroid responses at 30 min to 250 microg of ACTH (standard-dose test; SDT) was 25 microg (low-dose test; LDT). Saliva collection 30 min after LDT and SDT showed cortisol and aldosterone concentrations of at least 20.0 nmol/l and 100.0 pmol/l, respectively. These values were defined as normal steroid responses. Blunted salivary steroid responses to LDT and SDT were found in all patients with primary adrenal insufficiency. Subnormal salivary cortisol levels in response to LDT and SDT were found in all patients with secondary adrenal insufficiency. In five patients full recovery of adrenal function was demonstrated by both tests after steroid withdrawal. In the follow-up of four patients studied during the recovery period, subnormal SAF response after LDT and normal after SDT was demonstrated. Preservation of the adrenal glomerulosa was found in all the patients with secondary adrenal insufficiency through the normal rise in salivary aldosterone after both LDT and SDT. CONCLUSIONS:Adrenal function can be accurately investigated with simultaneous measurements of salivary cortisol and aldosterone in response to 25 microg of corticotrophin injected into the deltoid muscle. Our data suggest that this may become a useful and relatively noninvasive clinical tool to detect subclinical hypoadrenal states.
journal_name
Clin Endocrinol (Oxf)journal_title
Clinical endocrinologyauthors
Contreras LN,Arregger AL,Persi GG,Gonzalez NS,Cardoso EMdoi
10.1111/j.1365-2265.2004.02144.xkeywords:
subject
Has Abstractpub_date
2004-12-01 00:00:00pages
675-82issue
6eissn
0300-0664issn
1365-2265pii
CEN2144journal_volume
61pub_type
杂志文章abstract:OBJECTIVE:Diagnosing thyroid nodules preoperatively using traditional diagnostic tools - ultrasonography (US) and cytology - still carries a considerable degree of uncertainty, and surgery is recommended for a far from negligible number of patients simply for diagnostic purposes. Thyroid elastosonography (USE) and BRAF...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2012.04427.x
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Mutations in CYP21A2 lead to deficiency of 21-hydroxylase and can have either severe or moderate effects on phenotype, which can be prevented by early treatment. We studied long-term effects of this deficiency on phenotype in patients who had not been treated for prolonged periods and correlated these phenot...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2009.03550.x
更新日期:2009-11-01 00:00:00
abstract::The catechol oestrogen 2-hydroxyoestrone has been reported to lower serum prolactin concentrations acutely in normal women and it has been proposed that it may be effective in suppressing prolactin secretion in hyperprolactinaemic patients. Five women with hyperprolactinaemia and anovulation were studied. Following a ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1981.tb00678.x
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Thyroid cancer incidence has been increasing worldwide. Some suggest greater ascertainment of indolent tumours is the only driver, but others suggest there has been a true increase. Increases in Australia appear to have been among the largest in the world, so we investigated incidence trends in the Australia...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12724
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to examine (1) the diurnal variation in SHBG and (2) the inter-relationships of insulin, IGF-I, SHBG and IGFBP-1 over 24 hours in 10 women with anovulatory PCOS and compare them with weight-matched ovulatory controls. PATIENTS AND METHODS:The two groups comprised 10 anovulatory wom...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1995.tb01910.x
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:The effects of thiazide medication in patients with primary hyperparathyroidism (PHPT) have so far not been elucidated. The aim of this study was to analyse the extent to which the administration of thiazides may influence biochemical parameters and therefore the diagnosis of PHPT in a large cohort of patient...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.13046
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The Interleukin (IL)-10 polymorphic variants -1082G/A, -819C/T and -592C/A were linked with obesity, metabolic syndrome, and type 2 diabetes (T2DM). We investigated the hypothesis that IL-10 promoter polymorphisms may be associated with the progression of diabetic nephropathy (DN). DESIGN:Case-controlled st...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2008.03337.x
更新日期:2009-03-01 00:00:00
abstract::Two cases of Cushing's syndrome are reported in which apparently autonomous adrenal adenomata were associated with the presence of pituitary tumours. In one case the patient was apparently cured by unilateral adrenalectomy, although she was noted to have radiological evidence of an intrasellar tumour; serum cortisol w...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1995.tb00546.x
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:Human resistin gene (RETN) polymorphisms have been found to be associated with type 2 diabetes (T2DM), insulin resistance and/or obesity. We evaluated, in a 5-year prospective study, whether RETN polymorphisms could predict the progression of glycaemia in southern Chinese. DESIGN AND PATIENTS:We conducted a ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2006.02710.x
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:To examine the association between glycaemic control, insulin resistance and hyperandrogenism on cardiac autonomic function in peripubertal girls with type 1 diabetes. DESIGN:Prospective, clinic-based study of 125 girls with diabetes and 46 age-matched nondiabetic girls. MEASUREMENTS:Heart rate variability ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12238
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Recent studies have shown that parallel changes in body weight and bone mass can be partially mediated via circulating leptin. Therefore, among the hormones involved in bone and mineral metabolism, such as oestrogens, testosterone and parathormone, leptin has recently become a subject of considerable interest...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2008.03313.x
更新日期:2009-02-01 00:00:00
abstract::Familial neurohypophysial diabetes insipidus (FNDI) is a rare autosomal dominant syndrome stemming from the absence of arginine vasopressin (AVP). More than thirty-five different germline mutations in the arginine vasopressin-neurophysin II gene have been reported. These mutations are either in the signal peptide or s...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.2003.01667.x
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:While an association between androgens and the metabolic syndrome (MS) is well established in obese women, studies concerning this relationship are scarce in obese adolescent girls. Therefore, we analysed the relationships between androgens, MS and intima-media thickness (IMT) in this age-group. METHODS:In ...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2009.03710.x
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Growth hormone treatment in children with idiopathic short stature (ISS) leads to growth acceleration in the first years, but the effect on final height is still poorly documented. We therefore studied the long-term effect of GH therapy in children with idiopathic short stature. DESIGN:We have...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2265.1995.tb02644.x
更新日期:1995-04-01 00:00:00
abstract::Headache is very common in pituitary disease and is reported to be present in more than a third of all patients with pituitary adenomas. Tumour size, cavernous sinus invasion, traction or displacement of intracranial pain-sensitive structures such as blood vessels, cranial nerves and dura mater, and hormonal hypersecr...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/cen.12314
更新日期:2013-12-01 00:00:00
abstract::It is believed that the study of gonadal function of the child should be regarded as a whole, beginning with the fetus and ending with the adolescent. Gonadal function depends upon 3 levels of activities: 1) central level (extra-hypothalamic, hypothalamic, and anterior pituitary); 2) an intermediate level (gonadal a...
journal_title:Clinical endocrinology
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2265.1976.tb01985.x
更新日期:1976-09-01 00:00:00
abstract::Sleep history and pituitary function were studied and sleep polygraphy performed in 11 acromegalic patients before and after pituitary surgery. Excessive daytime sleepiness or habitual snoring or both together, as well as an elevated fasting level of serum GH occurred in all the patients. In five men but in none of th...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1987.tb02947.x
更新日期:1987-12-01 00:00:00
abstract:UNLABELLED:Objective To evaluate the effect of strontium ranelate (SR) on bone turnover markers in women with established osteoporosis previously treated with teriparatide (TPTD--recombinant human PTH 1-34). DESIGN PATIENTS: Twenty-two postmenopausal Caucasian women (aged 65.7 +/- 1.7 years) with established osteoporos...
journal_title:Clinical endocrinology
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1365-2265.2008.03342.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVES:The recent American Thyroid Association management guidelines suggest cervical ultrasonography (US) surveillance in patients with differentiated thyroid cancer (DTC). This study was conducted to identify predictive factors that can determine whether subsequent fine needle aspiration guided by ultrasound (US-...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2010.03915.x
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:We compared IGF-1 and IGFBP3 concentrations in a group of adults treated for brain tumours in childhood with those of matched controls, and investigated the relationship between the GH secretory pattern and IGF-1/IGFBP3 concentrations in the entire group. DESIGN:We performed 24 h serum GH profiles using 20 m...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1046/j.1365-2265.1998.00585.x
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:Conflicting data have been reported previously on the effects of oestrogen replacement therapy on glucose tolerance, and the effects on glycosylated haemoglobin GHbA(1c) have been studied only among diabetics. The objective of this study was to evaluate the effects on glucose and insulin metabolism among nond...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2265.2001.01208.x
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:Adult onset GH deficiency (GHD) is characterized by abnormalities of serum lipoprotein profiles and GH replacement results in favourable alterations in serum total and low density lipoprotein (LDL)-cholesterol. Preliminary evidence has indicated that the effect of GH replacement in this respect may be additiv...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2007.02935.x
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:The aim was to study the pharmacokinetic parameters and biological activity of a single dose of human recombinant IGF-I (rhIGF-I) administered to patients following major gastrointestinal surgery. DESIGN:A double blind placebo controlled externally randomized study of 30 patients; the study commencing 24 hou...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2265.1992.tb01486.x
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:Cytokines have an important role in orchestrating the pathophysiology in autoimmune thyroid disease. The aim of the current study was to analyse the expression of interleukin (IL)-14 and IL-16 in the thyroid tissue of patients with Graves' disease (GD), Hashimoto's thyroiditis (HT) or multinodular goitre (MN...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12810
更新日期:2015-11-01 00:00:00
abstract::The responses of plasma adrenocorticotrophin (ACTH), cortisol, growth hormone (GH) and prolactin to insulin-induced hypoglycaemia were studied in six lean male subjects (age 22-29 years). Intravenous insulin tests were performed with and without oxytocin infusion. Blood sugar nadir occurred at the onset of symptoms (t...
journal_title:Clinical endocrinology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2265.1988.tb01223.x
更新日期:1988-09-01 00:00:00
abstract::Sulpiride, a dopamine receptor blocker which raises prolactin, was given to six women with idiopathic amenorrhoea for 10 days and to eleven women with regular cycles for 3 to 6 months. The latter group developed galactorrhoea and amenorrhoea during treatment. Basal LH AND FSH concentrations showed no significant chang...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1978.tb01507.x
更新日期:1978-12-01 00:00:00
abstract:OBJECTIVE:The purpose of the current study was to investigate the diagnostic performance of high mobility group A2 (HMGA2) gene expression for differentiation of malignant thyroid nodules through a systematic review and meta-analysis. DESIGN:The MEDLINE/PubMed and EMBASE database, from the earliest available date of i...
journal_title:Clinical endocrinology
pub_type: 杂志文章,meta分析
doi:10.1111/cen.13853
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The aetiology of non-insulin dependent diabetes is unknown, but defective insulin secretion is a feature. The disease also has a strong genetic basis and first-degree relatives of patients have an increased risk of future diabetes. To investigate whether beta-cell dysfunction is an early feature of the diseas...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.1995.tb01873.x
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVE:Congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency (21-OHD) is characterized by high androgen levels, ambiguous genitalia or premature pubarche, increased height velocity and skeletal maturation. Considering the possibility of changes in the IGF system components depending on the state of c...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/j.1365-2265.2004.02075.x
更新日期:2004-07-01 00:00:00
abstract:CONTEXT:Germline mutations in four genes (RET, VHL, SDHB and SDHD) are detected in about 17% of patients with apparently sporadic pheochromocytoma. Thus, genetic screening of all patients with this disease is suggested for a rational diagnostic approach and management. OBJECTIVE:To report the clinical, biochemical and...
journal_title:Clinical endocrinology
pub_type: 杂志文章
doi:10.1111/cen.12032
更新日期:2013-03-01 00:00:00