Investigation of Single and Paired Measurements of Adrenocorticotropic Hormone for the Diagnosis of Pituitary Pars Intermedia Dysfunction in Horses

Journal of Veterinary Internal Medicine

D.I. Rendle¹  M. Duz²  J. Beech³  T. Parkin² 

[1] The Liphook Equine Hospital, Liphook, Hampshire, UK;School of Veterinary Medicine, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK;Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA

关键词: Cushing's disease;    Endocrinology;    Equine;    Laminitis;   

DOI  :  10.1111/jvim.12489

来源: Wiley

【 摘 要 】

Abstract

Background

Paired measurement of ACTH concentration may be more reliable than a single measurement.

Hypothesis/Objectives

To determine whether the mean of 2 measurements of ACTH concentration is more reliable in assessing pituitary pars intermedia dysfunction (PPID) than a single measurement.

Animals

Paired ACTH measurements were performed on (1) 148 occasions from 124 horses being investigated for PPID, (2) 90 occasions from 76 horses with PPID that were receiving treatment with pergolide, and (3) 63 occasions from 50 horses in which there was no clinical suspicion of PPID. Histologic examination of the pars intermedia was performed in 67 of the untreated horses.

Methods

Outcome of testing using single and the mean of paired samples was compared directly and both methods were compared against histology, which was considered the gold standard.

Results

Paired ACTH measurement altered binary classification as healthy or diseased in 6 of 211 cases, all off which had equivocal initial ACTH concentrations between 20 and 39 pg/mL. Using histology as the gold standard, optimal sensitivity and specificity for diagnosing PPID were 69.4 and 80.9%, respectively, for a single measurement and 72.2 and 76.2%, respectively, for paired measurements. The area under the receiver operating characteristic curve was 0.72 and 0.73 for single and paired measurements compared with histopathologic diagnosis, respectively.

Conclusions and Clinical Importance

Paired measurement of ACTH concentration offers no advantage over a single measurement.

【 授权许可】

Unknown   
Copyright © 2014 by the American College of Veterinary Internal Medicine