We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
LGC Clinical Diagnostics

Download Mobile App




ACTH Stimulation Test Results Reassessed

By LabMedica International staff writers
Posted on 12 May 2018
Print article
Image: A diagram of types of adrenal insufficiency; CRH: corticotropin-releasing hormone, ACTH: adrenocorticotropic hormone (Photo courtesy of US National Institute of Health).
Image: A diagram of types of adrenal insufficiency; CRH: corticotropin-releasing hormone, ACTH: adrenocorticotropic hormone (Photo courtesy of US National Institute of Health).
Cosyntropin (adrenocorticotropic hormone or ACTH) stimulation testing is considered the gold standard for investigating primary adrenal insufficiency (AI) and may be an effective alternative to insulin tolerance testing in the workup of secondary AI.

The time of day that ACTH stimulation testing takes place does not affect the percentages of failed, borderline, or passed results in the evaluation of AI. However, testing sites also have different practices about the time of day (morning versus afternoon) that ACTH testing takes place.

Scientists at Dalhousie University (Saint John, NB, Canada) conducted a retrospective study of all ACTH testing performed during a 10-year period to assess whether both 30- and 60-minute results are necessary and whether the timing of testing affects outcomes. In all, there were 431 ACTH stimulation tests; the team excluded 92 due to medications the patients were taking or because the patients had already been diagnosed with primary AI.

The cutoff for ACTH testing was 18 mcg/dL (500 nmol/L) with a test “fail” if both 30- and 60-minute results were below this level, a “borderline pass” if either a 30- or 60-minute value was below the cutoff, and a pass if results at both time frames were above the cutoff. The investigators considered the time of day in three blocks of time: early morning (between 08.00 and 10.00); late morning (between 10:01. and 12:00); and afternoon (after 12:00).

The scientists found that there were no differences at the different time intervals in mean cortisol levels at 30 (574.5, 559, 534 nmol/L, respectively) and 60 minutes (642, 623, 619 nmol/L, respectively) between groups. When comparing 30- versus. 60-min values using a cut-off of ≥500 nmol/L, 45 patients (13.4%) failed to reach the cut-off at 30 minutes, but met the cut-off at 60 minutes. Conversely, only two patients (0.6%) who met the cut-off at 30 minutes failed to reach it at 60 minutes.

The authors concluded that outcomes from ACTH testing are not affected by time of day. Furthermore, using a 30-minutes cortisol level in isolation results in more than one in seven patients having a false positive diagnosis of AI; a 60-minutes value of ≥500 nmol/L alone may be sufficient to diagnose AI in more than 99% of cases. The study was published in the April 2018 issue of the journal Clinical Biochemistry.

Related Links:
Dalhousie University

Platinum Member
COVID-19 Rapid Test
OSOM COVID-19 Antigen Rapid Test
One Step HbA1c Measuring System
GREENCARE A1c
Anti-Cyclic Citrullinated Peptide Test
GPP-100 Anti-CCP Kit
New
Gold Member
Fully Automated Cell Density/Viability Analyzer
BioProfile FAST CDV

Print article

Channels

Molecular Diagnostics

view channel
Image: The study showed the blood-based cancer screening test detects 83% of people with colorectal cancer with specificity of 90% (Photo courtesy of Guardant Health)

Blood Test Shows 83% Accuracy for Detecting Colorectal Cancer

Colorectal cancer is the second biggest cause of cancer deaths among adults in the U.S., with forecasts suggesting 53,010 people might die from it in 2024. While fewer older adults are dying from this... Read more

Hematology

view channel
Image: The Gazelle Hb Variant Test (Photo courtesy of Hemex Health)

First Affordable and Rapid Test for Beta Thalassemia Demonstrates 99% Diagnostic Accuracy

Hemoglobin disorders rank as some of the most prevalent monogenic diseases globally. Among various hemoglobin disorders, beta thalassemia, a hereditary blood disorder, affects about 1.5% of the world's... Read more

Microbiology

view channel
Image: The new platform is designed to perform blood-based diagnoses of nontuberculosis mycobacteria (Photo courtesy of 123RF)

New Blood Test Cuts Diagnosis Time for Nontuberculous Mycobacteria Infections from Months to Hours

Breathing in nontuberculous mycobacteria (NTM) is a common experience for many people. These bacteria are present in water systems, soil, and dust all over the world and usually don't cause any problems.... Read more

Industry

view channel
Image: These new assays are being developed for use on the recently introduced DxI 9000 Immunoassay Analyzer (Photo courtesy of Beckman Coulter)

Beckman Coulter and Fujirebio Expand Partnership on Neurodegenerative Disease Diagnostics

Beckman Coulter Diagnostics (Brea, CA, USA) and Fujirebio Diagnostics (Tokyo, Japan) have expanded their partnership focused on the development, manufacturing and clinical adoption of neurodegenerative... Read more
Copyright © 2000-2024 Globetech Media. All rights reserved.