A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin

Autores
Contreras, Liliana Noemí; Arregger, Alejandro Luis; Persi, Gabriel; Gonzalez, Soledad Natalia; Cardoso, Estela M. del Luján
Año de publicación
2004
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
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 µg) 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 ≥ 552·0 nmol/l and aldosterone ≥ 555·0 pmol/l concentrations at 30 min after 250 µg 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 µg of ACTH (standard‐dose test; SDT) was 25 µg (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 µg 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.
Fil: Contreras, Liliana Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Gonzalez, Soledad Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Cardoso, Estela M. del Luján. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Materia
Low-dose ACTH test
salivary cortisol
salivary aldosterone
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/108441
Acceder
id CONICETDig_55e8dbe750fd74ff74539dfc130ad98c
oai_identifier_str oai:ri.conicet.gov.ar:11336/108441
network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophinContreras, Liliana NoemíArregger, Alejandro LuisPersi, GabrielGonzalez, Soledad NataliaCardoso, Estela M. del LujánLow-dose ACTH testsalivary cortisolsalivary aldosteronehttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Objective: 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 µg) 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 ≥ 552·0 nmol/l and aldosterone ≥ 555·0 pmol/l concentrations at 30 min after 250 µg 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 µg of ACTH (standard‐dose test; SDT) was 25 µg (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 µg 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.Fil: Contreras, Liliana Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Gonzalez, Soledad Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaFil: Cardoso, Estela M. del Luján. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; ArgentinaWiley Blackwell Publishing, Inc2004-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/108441Contreras, Liliana Noemí; Arregger, Alejandro Luis; Persi, Gabriel; Gonzalez, Soledad Natalia; Cardoso, Estela M. del Luján; A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin; Wiley Blackwell Publishing, Inc; Clinical Endocrinology; 61; 6; 12-2004; 675-6820300-0664CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265.2004.02144.xinfo:eu-repo/semantics/altIdentifier/doi/10.1111/j.1365-2265.2004.02144.xinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:07:50Zoai:ri.conicet.gov.ar:11336/108441instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:07:51.234CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
title A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
spellingShingle A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
Contreras, Liliana Noemí
Low-dose ACTH test
salivary cortisol
salivary aldosterone
title_short A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
title_full A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
title_fullStr A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
title_full_unstemmed A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
title_sort A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin
dc.creator.none.fl_str_mv Contreras, Liliana Noemí
Arregger, Alejandro Luis
Persi, Gabriel
Gonzalez, Soledad Natalia
Cardoso, Estela M. del Luján
author Contreras, Liliana Noemí
author_facet Contreras, Liliana Noemí
Arregger, Alejandro Luis
Persi, Gabriel
Gonzalez, Soledad Natalia
Cardoso, Estela M. del Luján
author_role author
author2 Arregger, Alejandro Luis
Persi, Gabriel
Gonzalez, Soledad Natalia
Cardoso, Estela M. del Luján
author2_role author
author
author
author
dc.subject.none.fl_str_mv Low-dose ACTH test
salivary cortisol
salivary aldosterone
topic Low-dose ACTH test
salivary cortisol
salivary aldosterone
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.2
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv 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 µg) 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 ≥ 552·0 nmol/l and aldosterone ≥ 555·0 pmol/l concentrations at 30 min after 250 µg 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 µg of ACTH (standard‐dose test; SDT) was 25 µg (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 µg 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.
Fil: Contreras, Liliana Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Arregger, Alejandro Luis. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Persi, Gabriel. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Gonzalez, Soledad Natalia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
Fil: Cardoso, Estela M. del Luján. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Médicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Médicas; Argentina
description 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 µg) 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 ≥ 552·0 nmol/l and aldosterone ≥ 555·0 pmol/l concentrations at 30 min after 250 µg 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 µg of ACTH (standard‐dose test; SDT) was 25 µg (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 µg 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.
publishDate 2004
dc.date.none.fl_str_mv 2004-12
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/108441
Contreras, Liliana Noemí; Arregger, Alejandro Luis; Persi, Gabriel; Gonzalez, Soledad Natalia; Cardoso, Estela M. del Luján; A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin; Wiley Blackwell Publishing, Inc; Clinical Endocrinology; 61; 6; 12-2004; 675-682
0300-0664
CONICET Digital
CONICET
url http://hdl.handle.net/11336/108441
identifier_str_mv Contreras, Liliana Noemí; Arregger, Alejandro Luis; Persi, Gabriel; Gonzalez, Soledad Natalia; Cardoso, Estela M. del Luján; A new less-invasive and more informative low-dose ACTH test: salivary steroids in response to intramuscular corticotrophin; Wiley Blackwell Publishing, Inc; Clinical Endocrinology; 61; 6; 12-2004; 675-682
0300-0664
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2265.2004.02144.x
info:eu-repo/semantics/altIdentifier/doi/10.1111/j.1365-2265.2004.02144.x
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
publisher.none.fl_str_mv Wiley Blackwell Publishing, Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
_version_ 1842270020711743488
score 13.13397

Publicaciones similares