Investigation of the clinical significance of the growth hormone-releasing peptide-2 test for the diagnosis of secondary adrenal failure

Endocrine Journal

Takahisa Deguchi¹  Atsushi Shinnakasu¹  Yoshihiko Nishio¹  Singo Fujio²  Hiroshi Arimura¹  Hiroshi Hashiguchi¹  Mika Habu²  Akira Kikuchi¹  Aiko Arimura¹  Kazunori Arita²  Kiyoaki Yamamoto¹ 

[1] Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan;Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima 890-8520, Japan

关键词: Insulin tolerance test;    Pituitary;    Hypothalamus;    Adrenocorticotropic hormone;    Cortisol;   

DOI  :  10.1507/endocrj.EJ15-0587

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(28)The aim of this study was to evaluate the ability of the growth hormone-releasing peptide-2 (GHRP-2) test to clinically diagnose hypothalamo-pituitary-adrenal (HPA) axis failure.We performed an insulin tolerance test (ITT), CRH stimulation test, and GHRP-2 test on 47 patients suspected of having a hypothalamo-pituitary disorder.Patients with pituitary disorders had significantly lower ACTH responses to the GHRP-2 test compared to patients with hypothalamic disorders and the control group.In contrast, peak cortisol levels in response to the GHRP-2 test were significantly lower in both hypothalamic and pituitary disorder cases compared with the control group.Assignment of a cut-off value of 11.6 μg/dL for the peak serum cortisol level demonstrated that the GHRP-2 test was able to predict secondary hypoadrenalism with 88.9% specificity and 89.7% sensitivity.The responses of ACTH and cortisol to the GHRP-2 test had no correlation to the CRH test, suggesting the involvement of a different mechanism of ACTH secretion.These results indicate that the GHRP-2 test may induce ACTH secretion from the pituitary gland through direct stimulation.Although the GHRP-2 test does not have the same predictive value as the insulin tolerance test (ITT), it has similar diagnostic potential as the CRH stimulation test for evaluating HPA axis failure.

【 授权许可】

Unknown