唾液皮质醇对ACTH刺激的反应是对血清皮质醇的可靠替代品,用于评估缺上腺症
Nadia El-Farhan1, Sarah Tennant2, Seren E Rees3
1Department of Medical Biochemistry, Royal Gwent Hospital, Newport NP20 2UB, UK.
The Journal of clinical endocrinology and metabolism
|September 28, 2023
概括
唾液皮质醇在ACTH刺激测试中准确地反映了自由皮质醇水平,为血清皮质醇测量提供了可靠的替代方案,特别是当皮质醇结合球蛋白 (CBG) 水平发生变化时.
科学领域:
- 内分泌学 在内分泌学.
- 临床化学 临床化学
背景情况:
- 对ACTH刺激的血清总皮质醇反应是对上腺皮质功能的标准衡量标准.
- 血清皮质醇水平受到皮质醇结合型球蛋白 (CBG) 度的影响.
- 唾液皮质醇测量自由皮质醇,可以提供更准确的评估.
研究的目的:
- 在健康个体和那些有改变CBG的个体中,建立唾液皮质醇对ACTH刺激的反应.
- 在怀疑缺上腺症的患者 (SH患者) 中,使用下限基准值 (LRL) 评估唾液皮质醇的诊断性能.
主要方法:
- 在139名健康志愿者,24名OCP女性,10名LP患者和30名SH患者中进行了ACTH刺激测试 (250μg).
- 唾液皮质醇用液体染色学-并联质谱法测量.
- 通过将唾液LRL与SH患者的血清反应进行比较来评估诊断性能.
主要成果:
- 在健康志愿者中,30分钟内唾液皮质醇的平均值为19.3nmol/L.
- 在OCP女性和LP患者中,唾液皮质醇反应一致,不受CBG度变化的影响.
- 在SH患者的唾液和血清皮质醇之间的整体诊断一致性为79%.
结论:
- 唾液皮质醇对ACTH刺激的反应是一种可靠的替代血清测量方法.
- 唾液皮质醇在涉及改变CBG度的临床场景中尤为有价值.
- 这种方法增强了对上腺皮质功能的评估.
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