Article detail · 2008
Corticotropin Tests for Hypothalamic Pituitary Adrenal Insufficiency A Metaanalysis
Journal
The Journal of Clinical Endocrinology & MetabolismISSN 0021-972X
The ISSN points to another catalog journal; the name is from the YÖKSİS record.
- Year
- 2008
- Type
- article
Data source split
- YÖKSİS YÖKSİS article record
- YÖKSİS venue The Journal of Clinical Endocrinology & Metabolism
- Catalog match (ISSN) Journal of Clinical Endocrinology and Metabolism
- OpenAlex OpenAlex enrichment (abstract, citations, topics)
Abstract
OpenAlex · English
CONTEXT: The diagnostic value of tests for detecting hypothalamic-pituitary adrenal insufficiency (HPAI) is controversial. OBJECTIVE: Our objective was to compare standard-dose and low-dose corticotropin tests for diagnosing HPAI. DATA SOURCES: We searched the PubMed database from 1966-2006 for studies reporting diagnostic value of standard-dose or low-dose corticotropin tests, with patient-level data obtained from original investigators. STUDY SELECTION: Eligible studies had more than 10 patients. All subjects were evaluated because of suspicion for chronic HPAI, and patient-level data were available. We excluded studies with no accepted reference standard for HPAI (insulin hypoglycemia or metyrapone test) if test subjects were in the intensive care unit or if only normal healthy subjects were used as controls. DATA EXTRACTION: We constructed receiver operator characteristic (ROC) curves using patient-level data from each study and then merged results to create summary ROC curves, adjusting for study size and cortisol assay method. Diagnostic value of tests was measured by calculating area under the ROC curve (AUC) and likelihood ratios. DATA SYNTHESIS: Patient-level data from 13 of 23 studies (57%; 679 subjects) were included in the metaanalysis. The AUC were as follows: low-dose corticotropin test, 0.92 (95% confidence interval 0.89-0.94), and standard-dose corticotropin test, 0.79 (95% confidence interval 0.74-0.84). Among patients with paired data (seven studies, 254 subjects), diagnostic value of low-dose corticotropin test was superior to standard-dose test (AUC 0.94 and 0.85, respectively; P<0.001). CONCLUSIONS: Low-dose corticotropin test was superior to standard-dose test for diagnosing chronic HPAI, although it has technical limitations.
Topics
Citations
OpenAlex cited_by_count. Not a WoS or Scopus citation count; those sources have no separate column here.
387 citations
OpenAlex cited_by_count (cache / database)
5 publications in the local catalog that cite this work (OpenAlex reference match; not the full global list).
- Can basal cortisol measurement be an alternative to the insulin tolerance test in the assessment of the hypothalamic pituitary adrenal axis before and after pituitary surgery 2010
- Prospective investigation of anterior pituitary function in the acute phase and 12 months after pediatric traumatic brain injury 2013
- Evaluation of Growth Characteristics and Final Heights of Cases Diagnosed with Noonan Syndrome on GH Treatment 2025
- Optimal Low Dose Synacthen Stimulation Test Sampling Time for Diagnosis of Adrenal Insufficiency Using Monoclonal Antibody Immunoassay 2025
- Avoiding false-positive adrenal insufficiency diagnoses in children: insights from cortisol kinetics during pediatric low-dose ACTH stimulation test 2026