Assessing adrenal function in primary care settings with a single sample subcutaneous glucagon test - 10/08/11
, Amanda Drake, CHA, Dexiang Gao, PhD, Rebecca Ratliff, RN
Reprint requests: Michael S. Kappy, MD, PhD, The Children’s Hospital, 1056 E. 19th Ave, B-265, Denver, CO 80218.Résumé |
Objective |
To test the efficacy of the low-dose glucagon test in assessing adrenal gland function.
Study design |
Subcutaneous glucagon was used to assess the hypothalamo-pituitary-adrenal gland (HPA) axis in 215 healthy children. Concordance of this test with the low-dose intravenous ACTH test was established for 42 children. Glucagon testing was conducted for 150 minutes after subcutaneous glucagon administration and for 30 minutes after 1 μg intravenous ACTH.
Results |
Mean peak serum cortisol concentrations were 22.4 ± 0.6 μg/dL (SEM) after subcutaneous glucagon and 20.0 ± 0.6 μg/dL after intravenous ACTH. Specificity of 95% was found at peak cortisol concentrations of 9.5 and 12.5 μg/dL for the glucagon and ACTH tests, respectively. Concordance between the glucagon and ACTH tests was 90.5%.
Conclusions |
The glucagon test was found to be as good a test of the HPA axis as the ACTH test and had a 90.5% concordance with it. The ease of performing the glucagon test, namely, obtaining a single sample of blood 150 minutes after the subcutaneous administration of glucagon, makes it a useful method of assessing the HPA axis in primary care settings.
Le texte complet de cet article est disponible en PDF.Abbreviations : CNS, HD-ACTH, HPA, LD-ACTH
Plan
Vol 149 - N° 5
P. 682-686 - novembre 2006 Retour au numéro
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